Clinical Characteristics and Risk Factors for Intra-Abdominal Infection with Chryseobacterium indologenes after Orthotopic Liver Transplantation

Abstract

The incidence of hospital-acquired infections caused by Chryseobacterium indologenes (C. indologenes) is increasing. This study investigated the epidemiological and clinical features of C. indologenes intra-abdominal infections in patients who underwent orthotopic liver transplantation (OLT). In this retrospective study, 53 consecutive non-replicate clinical isolates of C. indologenes were collected and identified from the OLT patients at a tertiary care university hospital in Shanghai in 2017. Genetic relatedness of the isolates was determined by enterobacterial repetitive intergenic consensus polymerase chain reaction DNA fingerprinting. Antimicrobial susceptibility of the isolates was measured using the microdilution broth method. Nosocomial clonal transmission of C. indologenes was confirmed by bacterial homology analysis. All C. indologenes isolates were resistant to β-lactams, carbapenems, quinolones, and aminoglycosides, and showed susceptibility to trimethoprim–sulfamethoxazole and minocycline. Multivariate risk modelling revealed that ≥2 bed transfers and an operation time of ≥8 h were independent risk factors for C. indologenes intra-abdominal infection after OLT. A nomogram was constructed based on the screened risk factors, which showed good concordance and accuracy. Clonal dissemination of C. indologenes in OLT patients was demonstrated and several risk factors for intra-abdominal infections were identified. Epidemiological surveillance of this organism and extensive surveillance programs are imperative worldwide.