Klebsiella pneumoniae infections after liver transplantation: Drug resistance and distribution of pathogens, risk factors, and influence on outcomes

Table 1 Demographic, laboratory, and clinical variables of 406 liver transplantation recipients

Characteristics	Value
Recipient age (yr), mean ± SD	47.3 ± 10.6
Recipient gender, no. of female (%)	72 (17.7)
Recipient BMI, median (IQR), kg/m2	22.8 (20.8-25.1)
Hospital stay prior to LT, median (IQR), days	10.0 (1.0-22.3)
MELD score at LT, median (IQR)	23.0 (15.0-30.0)
Infection within 2 months prior to LT, n (%)	160 (39.4)
Pulmonary infection	140 (34.5)
Abdominal/biliary infection	6 (1.5)
Urinary tract infection	1 (0.2)
Multiple site infection1	13 (3.2)
Pre-LT use of broad-spectrum antibiotics	166 (40.9)
Underlying liver diseases, n (%)	406 (100)
Viral cirrhosis/necrosis/tumor	304 (74.9)
Alcoholic cirrhosis	31 (7.6)
Autoimmune hepatitis	15 (3.7)
Primary biliary cirrhosis	11 (2.7)
Mixed cirrhosis	19 (4.7)
Others2	26 (6.4)
Pre-LT type 2 diabetes, n (%)	48 (11.8)
Pre-LT creatinine, median (IQR), mg/dL	0.8 (0.7-1.0)
Pre-LT WBC count, median (IQR), × 109/L	5.2 (3.4-8.1)
Pre-LT lymphocyte count, median (IQR), × 109/L	0.8 (0.5-1.2)
Pre-LT platelet count, median (IQR), × 109/L	72 (43.8-106.5)
Pre-LT albumin level, median (IQR), g/L	34.5 (30.9-38.1)
Donor age (yr), mean ± SD	42.1 ± 13.0
Steatosis ≥ 30%, n (%)	42 (10.3)
Cold ischemia time, mean ± SD	6.2 ± 1.5
Duration of surgery, median (IQR), min	378.5 (333.0-425.0)
Intraoperative bleeding, median (IQR), mL	3000.0 (2000.0-5000.0)
Intraoperative RBC transfusion, median (IQR), units	12.0 (8.0-18.0)
Post-LT infections due to Klebsiella pneumoniae, n (%)	32 (7.9)
Post-LT infections due to CRKP, n (%)	21 (5.2)
Median interval between the onset of infections due to Klebsiella pneumoniae and LT, median (IQR), days	7.5 (2.0-17.8)
Post-LT immunosuppressant treatment, n (%)	406 (100)
Tacrolimus	395 (97.3)
Ciclosporin A	5 (1.2)
Mycophenolate mofetil/enteric-coated mycophenolate sodium	277 (68.2)
Sirolimus	5 (1.2)
Glucocorticoid	406 (100)
Basiliximab	214 (52.7)
Anti-thymocyte globulin	18 (4.4)
ALT on day 1 after LT, median (IQR), U/L	694.5 (383.0-1242.0)
Creatinine on day 3 after LT, median (IQR), mg/dL	0.9 (0.7-1.4)
Albumin level on day 1 after LT, median (IQR), g/L	37.2 (33.9-40.7)
Post-LT duration of urethral catheter, median (IQR), days	3.0 (2.0-5.0)
Post-LT mechanical ventilation, n (%)	94 (23.2)
Reoperation, n (%)	17 (4.2)
Acute rejection, n (%)	67 (16.5)
Post-LT renal replacement therapy, n (%)	19 (4.7)
ICU stay after LT, median (IQR), days	6.0 (5.0-7.0)
Hospitalization stay after LT, median (IQR), days	26.0 (21.0-30.0)
All-cause mortality within 6 months after LT, n (%)	32 (7.9)

¹There were 9 cases of pulmonary and abdominal/bile duct infections, 1 case of pulmonary and urinary tract infections, 1 case of pulmonary and bloodstream infections, 1 case of pulmonary and intracranial infections, and 1 case each of pulmonary, abdominal and bloodstream infections.

²There were 9 cases of cryptogenic cirrhosis, 5 cases of Budd-Chiari syndrome, 3 cases each of hepatolenticular degeneration and transplant liver failure, 2 cases each of drug-induced liver injury, polycystic liver, and familial hereditary amyloidosis.

ALT: Alanine aminotransferase; BMI: Body mass index; ICU: Intensive care unit; Fis: Fungal infections; IQR: Interquartile range; LT: Liver transplantation; MELD: Model for End-Stage Liver Disease; RBC: Red blood cell.