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

Table 6 Univariate and multivariate Logistic regression analysis of risk factors for 6-month all-cause mortality after liver transplantation, n (%)

Variables	Death(32)	Survival(374)	P value	OR (95%CI)
Total
Univariate analysis
Female sex	10 (31.3)	62 (16.6)	0.037
Recipient age ≥ 55 yr	14 (43.8)	87 (23.3)	0.010
Recipient BMI ≥ 25	4 (12.5)	102 (27.3)	0.068
MELD score at LT ≥ 22	24 (75.0)	205 (54.8)	0.027
Hospital stay prior to LT ≥ 7 d	24 (75.0)	215 (57.5)	0.053
Viral cirrhosis/necrosis/tumor	25 (78.1)	279 (74.6)	0.659
Alcoholic cirrhosis	1 (3.1)	30 (8.0)	0.513
Pre-LT diabetes	4 (12.5)	44 (11.8)	1.000
Pre-LT creatinine ≥ 2 mg/dL	6 (18.8)	23 (6.1)	0.008
Infection within 2 months prior to LT	19 (59.4)	141 (37.7)	0.016
Pre-LT WBC count ≥ 10 × 109/L	7 (21.9)	52 (13.9)	0.219
Pre-LT lymphocyte count ≤ 0.5 × 109/L	12 (37.5)	86 (23.0)	0.066
Pre-LT platelet count ≤ 50 × 109/L	8 (25.0)	127 (34.0)	0.302
Pre-LT albumin level < 30g/L	6 (18.8)	74 (19.8)	0.888
Donor age ≥ 50 yr	7 (21.9)	127 (34.0)	0.163
Steatosis ≥ 30%	3 (9.4)	39 (10.4)	1.000
Cold ischemia time ≥ 360 min	20 (62.5)	199 (53.2)	0.248
Duration of surgery ≥ 450 min	8 (25.0)	63 (16.8)	0.244
Intraoperative bleeding ≥ 3000 mL	26 (81.3)	211 (56.4)	0.006
Intraoperative RBC transfusion ≥ 12 U	25 (78.1)	196 (52.4)	0.005
ALT on day 1 after LT ≥ 1500 U/L	8 (25.0)	72 (19.3)	0.433
Creatinine on day 3 after LT ≥ 2 mg/dL	18 (56.3)	43 (11.5)	< 0.001
Albumin level on day 1 after LT < 30 g/L	6 (18.8)	25 (6.7)	0.564
Post-LT infections due to Klebsiella pneumoniae	6 (18.8)	26 (7.0)	0.017
Post-LT infections due to CRKP	6 (18.8)	15 (4.0)	< 0.001
Post-LT mechanical ventilation	19 (59.4)	75 (20.1)	< 0.001
Reoperation	3 (9.4)	14 (3.7)	0.286
Acute rejection	4 (12.5)	63 (16.8)	0.525
Post-LT renal replacement therapy	8 (25.0)	11 (2.9)	< 0.001
Glucocorticoidse ≥ 1500 mg	19 (59.4)	237 (63.4)	0.653
Basiliximab use ≥ 40 mg	10 (31.3)	149 (39.8)	0.339
Anti-thymocyte globulin use	1 (3.1)	17 (4.5)	1.000
Multivariate analysis
Female sex			0.031	2.829 (1.098-7.288)
Intraoperative RBC transfusion ≥ 12 U			0.016	3.466 (1.259-9.543)
Creatinine on day 3 after LT ≥ 2 mg/dL			< 0.001	9.724 (4.077-23.194)
Post-LT infections due to CRKP			0.008	5.330 (1.534-18.524)
Post-LT mechanical ventilation			0.001	4.118 (1.790-9.476)

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