Surgical site infection in liver transplant patients: evidence from real-world studies
Md Azharuddin1, Manju Sharma2.
1Pharmaceutical Medicine, Jamia Hamdard, New Delhi, India; 2Pharmacology, Jamia Hamdard, New Delhi, India
Objectives: Surgical site infection (SSI) is a common and postoperative complication in patients who underwent solid organ transplant and it makes extensive healthcare burden. So far, the pooled prevalence and microorganisms causing SSI among liver transplantation has not been reported well. This evidence based systematic literature review and meta-analytic approach aimed to find the pooled prevalence of SSI.
Methods: A systematic literature search on PubMed/Medline, Embase was conducted to identify the study determining the prevalence of SSI among patients who underwent liver transplantation. We calculated pooled prevalence (%) with 95% confidence interval (CI) with random-effect model. A meta-analysis was performed using “meta” package through R 3.5.0. software.
Results: A total of 16 studies with 6,012 studied patients were included in this analysis. The rate of SSI was ranged between 9.0% and 96.4%. The pooled prevalence of SSI was 28.52% (95% CI: 17.19 to 41.01%) with high degree of heterogeneity (I2 = 99%, heterogeneity-p <0.01). The included studies reported higher percentage of organ-space SSI (70.2%), followed by incisional, superficial and deep SSI. The incidence rate of SSI was ranged from 0.34-10.3 episodes per 100 transplantation. Staphylococcus aureus (76.5%) was the most common pathogen identified, followed by Coagulase-negative staphylococci (35.0%), Escherichia coli (21.25%), Enterococcus faecium and Staphylococcus epidermidis (12.5%), and Candida albicans (6.25%).
Conclusions: The current result suggests the overall prevalence of SSI infection was noted high. However, due to high degree of heterogeneity, resulting considerable amount of clinical uncertainty regarding the prevalence of SSI among patients underwent liver transplantation. Therefore, studies are required to confirm the present findings.
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