Management of bacterial and fungal infections in end stage liver disease and liver transplantation: Current options and future directions

Table 3 Management of infections in liver transplant recipients

Population/ infection	Risk factor and type of infection	Management	Ref.
Liver transplant candidates/all infections	Donor-derived. Active/latent infections. Vaccine-preventable infection.	Donor screening. Careful patient history and physical examination. Identification of infections requiring therapy. Immunization.	[160-165]
Liver transplant recipients/bacterial	Nosocomial infections (ICU, invasive devices). Recurrent infections (anatomical defects). Immunosuppression.	Peri-transplant antibiotic prophylaxis (< 48 h). Prompt diagnostic workup (uncommon presentations, opportunisms). Source control when needed.	[76,83,160]
Liver transplant candidates and recipients/MDRO	Colonization (MRSA, VRE, CRE) linked to increased risk of infections. Risk of transmission between patients and across wards.	Surveillance cultures (CRE, VRE, MRSA) and decolonization (MRSA). Infection control (hand hygiene, isolation, contact precautions).	[102,112,164]

LT: Liver transplantation; ICU: Intensive care unit; MDRO: Multidrug-resistant organisms; MRSA: Methicillin-resistant Staphylococcus aureus; VRE: Vancomycin-resistant enterococci; CRE: Carbapenem-resistant Enterobacteriaceae.