High mortality associated with gram-negative bacterial bloodstream infection in liver transplant recipients undergoing immunosuppression reduction

Table 1 Characteristics of liver transplant recipients with bloodstream infection in terms of bacterial pathogens, n (%)

Variable	Gram-positive BSI, n = 42	Gram-negative BSI, n = 28	P value
Age in yr, mean ± SD	51.0 ± 10.5	47.66 ± 13.01	0.228
Female sex	9 (21.4)	8 (28.6)	0.495
Etiology of liver transplant
Hepatocellular carcinoma	13 (31.0)	7 (25.0)	0.589
Hepatitis B virus	20 (47.6)	13 (46.4)	0.922
Others	9 (21.4)	8 (28.6)	0.495
Baseline immunosuppressive treatment
Prednisone	18 (42.9)	12 (42.9)	0.596
Tacrolimus	31 (73.8)	18 (64.3)	0.833
Cyclosporin	7 (16.7)	5 (17.9)	0.897
Mycophenolate mofetil	35 (83.3)	17 (60.7)	0.034
BSI characteristics
Early BSI1	41 (97.6)	26 (92.9)	0.718
Septic shock	0	4 (14.3)	NA
BSI source, episodes	n = 45	n = 29
Primary	10 (23.8)	3 (10.7)	0.318
Surgical wound	20 (47.6)	0	NA
Biliary tract	5 (11.9)	7 (25.0)	0.246
Urinary tract	1 (2.4)	6 (21.4)	0.025
Central venous catheter	2 (4.8)	2 (7.1)	0.649
Intra-abdominal	1 (2.4)	9 (32.1)	0.001
Respiratory tract	6 (14.3)	5 (17.9)	0.833
Management of infection
Empiric therapy	31 (73.8)	14 (50.0)	0.126
Target therapy	11 (26.2)	12 (42.9)	0.201
Source control	2 (4.8)	3 (10.7)	0.608
Length of stay in d, median (IQR)	18 (15-26.8)	24.5 (18-39)	0.055
From the day of transplantation to onset of BSI in d, median (IQR)	4 (1-6)	12 (8-41)	0.048
Patient outcome
Died	2 (4.8)	11 (39.3)	0.001
Suspected rejection2	3 (7.1)	7 (25.0)	0.081
Microbiological clearance	43 (95.6)	18 (62.1)	0.001
IS reduction	5 (11.9)	23 (82.1)	< 0.001
Complete IS withdrawal	3 (7.1)	15 (53.6)	< 0.001
Length of IS withdrawal in d	6.3 (2-10)	12.6 (4-25)	0.171

¹Within 6 mo after liver transplantation.

²Within 90 d after bloodstream infection. BSI: bloodstream infection; IQR: Interquartile range; IS: Immunosuppression; NA: Not applicable; SD: Standard deviation.