Streptococcus salivarius bacteremia and spontaneous bacterial peritonitis in liver transplantation candidates

Manjushree Gautam, Kapil B. Chopra, David D. Douglas, Rebecca A. Stewart, Shimon Kusne

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Bacterial infections are a serious complication of end-stage liver disease (ESLD) that occurs in 20% to 60% of patients. We retrospectively reviewed medical records of patients with ESLD who were identified by our microbiology laboratory as having Streptococcus salivarius bacteremia. Of 592 patients listed for transplantation between January 1998 and January 2006, 9 (1.5%) had 10 episodes of S salivarius bacteremia. Of 2 patients already receiving quinolone prophylaxis for spontaneous bacterial peritonitis (SBP), 1 later presented with a second episode. The male-to-female ratio was 1:1.2. Medians for age, Model for End-Stage Liver Disease score, and Child-Turcotte-Pugh score were 50 years, 17, and 10, respectively. Presenting symptoms and signs in 10 episodes of infection were ascites (in 8 episodes), elevated temperature (6), abdominal pain (5), and encephalopathy (4). Median laboratory values included: white blood cell count, 15.1 × 109/L; creatinine, 0.9 mg/dL; albumin, 3.1 gm/dL; aspartate aminotransferase, 64 U/L; alanine aminotransferase, 52.5 U/L; ammonia, 67 μg/dL; and prothrombin time, 17.3 seconds. Ascitic fluid in patients with peritonitis showed a median white blood cell count of 466 cells/mm3 (range, 250-12,822 cells/mm3), with 66% polymorphs, protein of 0.9 gm/dL, and albumin of 0.4 gm/dL. S salivarius may cause primary bacteremia and SBP in liver transplantation candidates despite quinolone prophylaxis.

Original languageEnglish (US)
Pages (from-to)1582-1588
Number of pages7
JournalLiver Transplantation
Volume13
Issue number11
DOIs
StatePublished - Nov 2007

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Bacteremia
Peritonitis
Liver Transplantation
End Stage Liver Disease
Quinolones
Leukocyte Count
Albumins
Ascitic Fluid
Prothrombin Time
Brain Diseases
Aspartate Aminotransferases
Microbiology
Alanine Transaminase
Ammonia
Bacterial Infections
Ascites
Alanine
Abdominal Pain
Signs and Symptoms
Medical Records

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Streptococcus salivarius bacteremia and spontaneous bacterial peritonitis in liver transplantation candidates. / Gautam, Manjushree; Chopra, Kapil B.; Douglas, David D.; Stewart, Rebecca A.; Kusne, Shimon.

In: Liver Transplantation, Vol. 13, No. 11, 11.2007, p. 1582-1588.

Research output: Contribution to journalArticle

Gautam, Manjushree ; Chopra, Kapil B. ; Douglas, David D. ; Stewart, Rebecca A. ; Kusne, Shimon. / Streptococcus salivarius bacteremia and spontaneous bacterial peritonitis in liver transplantation candidates. In: Liver Transplantation. 2007 ; Vol. 13, No. 11. pp. 1582-1588.
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