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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Assessment of pathogens and risk factors associated with bloodstream infection in the year after pediatric liver transplantation
Yeong Eun Kim, Ho Jung Choi, Hye-Jin Lee, Hyun Ju Oh, Mi Kyoung Ahn, Seak Hee Oh, Jung-Man Namgoong, Dae Yeon Kim, Won Kyoung Jhang, Seong Jong Park, Dong-Hwan Jung, Deok Bog Moon, Gi-Won Song, Gil-Chun Park, Tae-Yong Ha, Chul-Soo Ahn, Ki-Hun Kim, Shin Hwang, Sung Gyu Lee, Kyung Mo Kim
Yeong Eun Kim, Ho Jung Choi, Hye-Jin Lee, Hyun Ju Oh, Mi Kyoung Ahn, Seak Hee Oh, Won Kyoung Jhang, Seong Jong Park, Kyung Mo Kim, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul 05505, South Korea
Jung-Man Namgoong, Dae Yeon Kim, Division of Pediatric Surgery, Department of Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul 05505, South Korea
Dong-Hwan Jung, Deok Bog Moon, Gi-Won Song, Gil-Chun Park, Tae-Yong Ha, Chul-Soo Ahn, Ki-Hun Kim, Shin Hwang, Sung Gyu Lee, Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
Author contributions: Oh SH, Namgoong JM, and Kim KM designed the study; Kim YE and Oh SH wrote the manuscript and interpreted the data; Kim YE, Choi HJ, Lee HJ, Oh HJ, and Ahn MK collected patient data; Jhang WK and Park SJ were responsible for patient care and data collection during the intensive care unit stay; Namgoong JM, Kim DY, Jung DH, Moon DB, Song GW, Park GC, Ha TY, Ahn CS, Kim KH, Hwang S, and Lee SG participated in surgery and contributed to the treatment of complications related to surgery and the development of surgical technology; all authors have read and approve the final manuscript.
Supported by Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI); Ministry of Health & Welfare, Republic of Korea, No. HR21C0198.
Institutional review board statement: This study was approved by the Institutional Review Board of the Asan Medical Center, No. S2021-1917-0001.
Informed consent statement: Patients were not required to give informed consent to the study because this retrospective analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Seak Hee Oh, MD, PhD, Associate Professor, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-Gu, Seoul 05505, South Korea.
seakhee.oh@amc.seoul.kr
Received: September 15, 2021
Peer-review started: September 15, 2021
First decision: November 7, 2021
Revised: November 20, 2021
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: March 21, 2022
Processing time: 182 Days and 14.4 Hours
ARTICLE HIGHLIGHTS
Research background
Bloodstream infection (BSI) is one of the most significantly adverse events that can occur after liver transplantation (LT) in children. However, risk analysis of post-LT BSI is poorly studied in children.
Research motivation
Our findings are an important step in improving hospital policies for pediatric LT patients and reducing incidence of BSI.
Research objectives
To analyze the profile of post-LT BSIs in children and their risk factor.
Research methods
Clinical data, collected from medical charts of children (n = 378) who underwent primary LT, were retrospectively reviewed.
Research results
BSI was observed in 28% of patients after pediatric LT and affecting survival outcomes. The most common pathogenic organisms identified were Coagulase-negative staphylococci. About half of the BSIs were of unknown origin. Young age (≤ 1.3 year), growth failure, liver support system, and hospital stay of > 44 d were independently associated with BSI in the year after LT.
Research conclusions
Our retrospective study of pediatric patients of LT revealed that BSI was frequently observed and affected the survival outcomes. The profile of the pathogens, onset, and origin site of BSI may be informative to establish individual policy in each surgery center against BSI after the transplant.
Research perspectives
The profile of BSI may inform clinical treatment and management in high-risk children after LT.
