To explore the distribution and drug resistance of common pathogens in abdominal and thoracic infection after liver transplantation.

Clinical data of 343 recipients underwent liver transplantation were analyzed retrospectively from January 2011 to December 2017 in the Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University. The occurrence of perioperative abdominal and thoracic infection, common pathogens and drug resistance were analyzed. Chi-square test was used to compare the common pathogenic bacteria infections between abdomen and thorax, P<0.05 was statistically significant.

In 343 recipients of liver transplantation, 48 recipients got abdominal infection, 61 recipients got thoracic infection, 10 recipients got both abdominal and horacic infection, and 15 recipients died of infection. 106 strains of pathogenic bacteria were cultured by abdominal drainage, and the most common pathogenic in abdominal infection were enterococcus faecium [19.8% (21/106)], acinetobacter baumannii [15.1%(16/106)] and staphylococcus haemolyticus [11.3% (12/106)]. 99 strains of pathogenic bacteria were cultured by thoracic drainage, and the most common pathogenic in thoracic infection were acinetobacter bauman [26.3%(26/99)], pseudomonas aeruginosa [18.2%(18/99)] and klebsiella pneumoniae [17.2%(17/99)]. The occurrence of common pathogens (acinetobacter baumannii, enterococcus faecium, staphylococcus haemolyticus, pseudomonas aeruginosa and klebsiella pneumoniae) between abdominal and thoracic infection were significantly different (χ²=3.92、135.62、162.14、11.09、6.81, P all<0.05). Drug susceptibility test showed that acinetobacter baumannii was resistant to penicillins, quinolones and carbapenems (90%), but sensitive to tegacycline (27%). The resistance rate of pseudomonas aeruginosa to carbapenems and tegacycline was the lowest (11%). The resistance rate of klebsiella pneumoniae to amikacin and tegacycline was the lowest (6%). Gram-positive cocci (enterococcus faecium and staphylococcus hemolyticus) were most sensitive to teicoplanin, vancomycin and tegacycline. Fungi was most sensitive to fluconazole.

The incidences of perioperative abdominal infection and thoracic infection are both high after liver transplantation, and the distribution of pathogenic bacteria have their own characteristics. Postoperative patients should be actively and repeatedly tested for pathogen and use effective antibiotics according to drug susceptibility results.