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

Table 4 Univariate and multivariate logistic regression analysis of risk factors for infections due to Klebsiella pneumoniae within 3 months after liver transplantation, n (%)

Variables	With K. pneumoniae infections(32)	Without K. pneumoniae infections(374)	P value	OR (95%CI)
Total
Univariate analysis
Female sex	12 (37.5)	60 (16.0)	0.002
Recipient age ≥ 55 yr	10 (31.3)	91 (24.3)	0.385
Recipient BMI ≥ 25	9 (28.1)	97 (25.9)	0.787
MELD score at LT ≥ 22	23 (71.9)	206 (55.1)	0.066
Hospital stay prior to LT ≥ 7 d	23 (71.9)	216 (57.8)	0.119
Viral cirrhosis/necrosis/tumor	21 (65.6)	283 (75.7)	0.209
Alcoholic cirrhosis	3 (9.4)	28 (7.5)	0.969
Pre-LT diabetes	7 (21.9)	41 (11.0)	0.067
Pre-LT use of broad-spectrum antibiotics ≥ 3 d	16 (50.0)	150 (40.1)	0.275
Pre-LT creatinine ≥ 2 mg/dL	1 (3.1)	28 (7.5)	0.574
Infection within 2 months prior to LT	17 (53.7)	143 (38.2)	0.098
Pre-LT WBC count ≥ 10 × 109/L	4 (12.5)	55 (14.7)	0.937
Pre-LT lymphocyte count ≤ 0.5 × 109/L	6 (18.8)	92 (24.6)	0.458
Pre-LT platelet count ≤ 50 × 109/L	12 (37.5)	123 (32.9)	0.595
Pre-LT albumin level < 30 g/L	9 (28.1)	71 (19.0)	0.212
Donor age ≥ 50 yr	13 (40.6)	121 (32.4)	0.340
Steatosis ≥ 30%	2 (6.3)	40 (10.7)	0.624
Cold ischemia time ≥ 360 min	15 (46.9)	189 (50.5)	0.691
Duration of surgery ≥ 450 min	10 (31.3)	61 (16.3)	0.033
Intraoperative bleeding ≥ 3000 mL	23 (71.9)	214 (57.2)	0.101
Intraoperative RBC transfusion ≥ 12 U	20 (62.5)	201 (53.7)	0.340
ALT on day 1 after LT ≥ 1500U/L	14 (43.8)	66 (17.6)	<0.001
Creatinine on day 3 after LT ≥ 2 mg/dL	4 (12.5)	57 (15.2)	0.874
Albumin level on day 1 after LT < 30 g/L	4 (12.5)	24 (6.4)	0.347
Post-LT duration of urethral catheter ≥ 4 d	22 (68.8)	167 (44.7)	0.009
Post-LT mechanical ventilation	13 (40.6)	81 (21.7)	0.015
Reoperation	3 (9.4)	14 (3.7)	0.286
Acute rejection	6 (18.8)	61 (16.3)	0.721
Post-LT renal replacement therapy	3 (9.4)	16 (4.3)	0.382
Glucocorticoidse ≥ 1500 mg	21 (65.6)	235 (62.8)	0.754
Basiliximab use ≥ 40 mg	14 (43.8)	145 (38.8)	0.580
Anti-thymocyte globulin use	4 (12.5)	14 (3.7)	0.063
Multivariate analysis
Female sex			0.012	2.827 (1.256-6.364)
Pre-LT diabetes			0.036	2.794 (1.070-7.294)
ALT on day 1 after LT ≥ 1500U/L			0.001	3.645 (1.671-7.950)
Post-LT duration of urethral catheter ≥ 4 d			0.046	2.266 (1.016-5.054)

ALT: Alanine aminotransferase; BSIs: Bloodstream infections; CI: Confidence intervals; LT: Liver transplantation; MELD: Model for End-Stage Liver Disease; OR: Odds ratios; RBC: Red blood cell; BMI: Body mass index; K. pneumoniae: Klebsiella pneumoniae.