Volume 14 Issue 2
Mar.  2023
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Xu Jing, Zhao Yuanyuan, Chen Zhishui, et al. Efficacy of perioperative use of tigecycline in preventing infection and incidence of hypofibrinogenemia in liver transplant recipients[J]. ORGAN TRANSPLANTATION, 2023, 14(2): 241-247. doi: 10.3969/j.issn.1674-7445.2023.02.010
Citation: Xu Jing, Zhao Yuanyuan, Chen Zhishui, et al. Efficacy of perioperative use of tigecycline in preventing infection and incidence of hypofibrinogenemia in liver transplant recipients[J]. ORGAN TRANSPLANTATION, 2023, 14(2): 241-247. doi: 10.3969/j.issn.1674-7445.2023.02.010

Efficacy of perioperative use of tigecycline in preventing infection and incidence of hypofibrinogenemia in liver transplant recipients

doi: 10.3969/j.issn.1674-7445.2023.02.010
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  • Corresponding author: Wei Lai, Email: weilai@tjh.tjmu.edu.cn
  • Received Date: 2022-10-31
    Available Online: 2023-03-15
  • Publish Date: 2023-03-15
  •   Objective  To evaluate the efficacy of perioperative use of tigecycline in preventing infection and the incidence of hypofibrinogenemia in liver transplant recipients.  Methods  Clinical data of 40 liver transplant recipients given with tigecycline to prevent infection were retrospectively analyzed. The incidence of infection in recipients and donor-derived infection were analyzed. The changes of clinical indexes in recipients during, upon the completion and (7±2) d after tigecycline treatment were analyzed, respectively. The incidence and treatment of hypofibrinogenemia were summarized.  Results  Among 40 liver transplant recipients, 2 cases were infected by aspergillus niger and cytomegalovirus, out of the antibacterial spectrum of tigecycline. After adjusting the anti-infection regimen, the infection was properly controlled. Liver allografts were positive for relevant culture in 9 cases, whereas none of them progressed into donor-derived infection. Approximately at postoperative 2 weeks, all 40 recipients restored liver function and were discharged from hospital. Among them, 6 recipients developed hypofibrinogenemia complicated with coagulation disorder at postoperative 2-4 d, whereas transaminase level, bilirubin level and infection-related indexes were gradually decreased after liver transplantation, and albumin level was stable. After supplemented with human fibrinogen and prothrombin complex, coagulation function was improved, but fibrinogen level persistently declined. After terminating use of tigecycline, fibrinogen level was gradually restored to normal range, which might be an adverse drug reaction induced by tigecycline.  Conclusions  Perioperative anti-infection regimen including tigecycline may reduce the incidence of infection caused by sensitive bacteria in liver transplant recipients. Nevertheless, the incidence of hypofibrinogenemia should be intimately monitored throughout the use of tigecycline.

     

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  • [1]
    SHBAKLO N, TANDOIF, LUPIA T, et al. Bacterial and viral infections in liver transplantation: new insights from clinical and surgical perspectives[J]. Biomedicines, 2022, 10(7): 1561. DOI: 10.3390/biomedicines10071561.
    [2]
    KINN PM, INCE D. Outpatient and peri-operative antibiotic stewardship in solid organ transplantation[J]. Transpl Infect Dis, 2022, 24(5): e13922. DOI: 10.1111/tid.13922.
    [3]
    中华医学会器官移植学分会围手术期管理学组. 肝衰竭肝移植围手术期管理中国专家共识(2021版)[J]. 中华消化外科杂志, 2021, 20(8): 835-840. DOI: 10.3760/cma.j.cn115610-20210626-00312.

    Perioperative Management Group of Branch of Organ Transplantation of Chinese Medical Association. Chinese expert consensus on perioperative management of liver transplantation in patients with liver failure (2021 edition) [J]. Chin J Dig Surg, 2021, 20(8): 835-840. DOI: 10.3760/cma.j.cn115610-20210626-00312.
    [4]
    ELNASSER Z, ELSAMARNEH R, OBEIDAT H, et al. In-vitro activity of tigecycline against multidrug-resistant Gram negative bacteria: the experience of a university hospital[J]. J Infect Public Health, 2021, 14(4): 478-483. DOI: 10.1016/j.jiph.2020.12.013.
    [5]
    VYAGHOUBI S, ZEKIY AO, KRUTOVA M, et al. Tigecycline antibacterial activity, clinical effectiveness, and mechanisms and epidemiology of resistance: narrative review[J]. Eur J Clin Microbiol Infect Dis, 2022, 41(7): 1003-1022. DOI: 10.1007/s10096-020-04121-1.
    [6]
    MEI H, YANG T, WANG J, et al. Efficacy and safety of tigecycline in treatment of pneumonia caused by MDR acinetobacter baumannii: a systematic review and meta-analysis[J]. J Antimicrob Chemother, 2019, 74(12): 3423-3431. DOI: 10.1093/jac/dkz337.
    [7]
    LAPLANTE KL, DHAND A, WRIGHT K, et al. Re-establishing the utility of tetracycline-class antibiotics for current challenges with antibiotic resistance[J]. Ann Med, 2022, 54(1): 1686-1700. DOI: 10.1080/07853890.2022.2085881.
    [8]
    DOIY. Treatment options for carbapenem-resistant Gram-negative bacterial infections[J]. Clin Infect Dis, 2019, 69(Suppl 7): S565-S575. DOI: 10.1093/cid/ciz830.
    [9]
    关于印发医院感染诊断标准(试行)的通知[A/OL]. [2022-10-16]. http://www.nhc.gov.cn/wjw/gfxwj/201304/37cad8d95582456d8907ad04a5f3bd4c.shtml.
    [10]
    PIANO S, SINGH V, CARACENI P, et al. Epidemiology and effects of bacterial infections in patients with cirrhosis worldwide[J]. Gastroenterology, 2019, 156(5): 1368-1380. DOI: 10.1053/j.gastro.2018.12.005.
    [11]
    HELDMAN MR, GUO K, NELSON B, et al. Treatment of multidrug-resistant Gram-negative bacilli after solid organ transplant: outcomes and complications[J]. Transpl Infect Dis, 2021, 23(1): e13474. DOI: 10.1111/tid.13474.
    [12]
    POUCH SM. New drugs for difficult bugs: management of multidrug-resistant Gram-negative infections in solid organ transplant recipients[J]. Curr Opin Organ Transplant, 2021, 26(4): 424-431. DOI: 10.1097/MOT.0000000000000890.
    [13]
    BRATZLER DW, DELLINGER EP, OLSEN KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery[J]. Surg Infect (Larchmt), 2013, 14(1): 73-156. DOI: 10.1089/sur.2013.9999.
    [14]
    WU X, LONG G, PENG W, et al. Drug resistance and risk factors for acquisition of Gram-negative bacteria and carbapenem-resistant organisms among liver transplant recipients[J]. Infect Dis Ther, 2022, 11(4): 1461-1477. DOI: 10.1007/s40121-022-00649-1.
    [15]
    ZHONG L, MEN TY, LI H, et al. Multidrug-resistant Gram-negative bacterial infections after liver transplantation - spectrum and risk factors[J]. J Infect, 2012, 64(3): 299-310. DOI: 10.1016/j.jinf.2011.12.005.
    [16]
    申存毅, 薛峰, 李亚鹏, 等. 肝移植后发生腹腔感染的危险因素分析[J]. 中华消化外科杂志, 2021, 20(11): 1184-1190. DOI: 10.3760/cma.j.cn115610-20211008-00491.

    SHEN CY, XUE F, LI YP, et al. Risk factors analysis of abdominal infection after liver transplantation[J]. Chin J Dig Surg, 2021, 20(11): 1184-1190. DOI: 10.3760/cma.j.cn115610-20211008-00491.
    [17]
    方翊天, 吴若林, 黄帆, 等. 肝移植术后多重耐药菌感染危险因素的单中心临床研究[J]. 器官移植, 2021, 12(2): 197-202. DOI: 10.3969/j.issn.1674-7445.2021.02.010.

    FANG YT, WU RL, HUANG F, et al. Risk factors of multi-drug resistant organism infection after liver transplantation: a single-center clinical trial[J]. Organ Transplant, 2021, 12(2): 197-202. DOI: 10.3969/j.issn.1674-7445.2021.02.010.
    [18]
    YE QF, ZHOU W, WAN QQ. Donor-derived infections among Chinese donation after cardiac death liver recipients[J]. World J Gastroenterol, 2017, 23(31): 5809-5816. DOI: 10.3748/wjg.v23.i31.5809.
    [19]
    ISON MG, GROSSI P, AST Infectious Diseases Community of Practice. Donor-derived infections in solid organ transplantation[J]. Am J Transplant, 2013, 13(Suppl 4): 22-30. DOI: 10.1111/ajt.12095.
    [20]
    TONG L, HU XG, HUANG F, et al. Clinical impacts and outcomes with possible donor-derived infection in infected donor liver transplantation: a single-center retrospective study in China[J]. J Infect Dis, 2020, 221(Suppl 2): S164-S173. DOI: 10.1093/infdis/jiz591.
    [21]
    USHIRO-LUMB I, THORBURN D. Risk of transmission of infections to others after donor-derived infection transmissions[J]. Transpl Infect Dis, 2022, 24(2): e13791. DOI: 10.1111/tid.13791.
    [22]
    HUANG JF, MIAO Q, CHENG JW, et al. Metagenomic next-generation sequencing versus traditional laboratory methods for the diagnosis and treatment of infection in liver transplantation[J]. Front Cell Infect Microbiol, 2022, 12: 886359. DOI: 10.3389/fcimb.2022.886359.
    [23]
    ZHAO D, GUO L, LIAN D, et al. Diagnostic value and clinical application of mNGS for post-liver transplantation infection: a cross-sectional study with case reports[J]. Front Microbiol, 2022, 13: 919363. DOI: 10.3389/fmicb.2022.919363.
    [24]
    赵云, 赵礼金. 肝移植术后感染相关危险因素的研究进展[J]. 临床肝胆病杂志, 2021, 37(8): 1957-1962. DOI: 10.3969/j.issn.1001-5256.2021.08.046.

    ZHAO Y, ZHAO LJ. Research advances in the risk factors for infection after liver transplantation[J]. J Clin Hepatol, 2021, 37(8): 1957-1962. DOI: 10.3969/j.issn.1001-5256.2021.08.046.
    [25]
    LIU J, YAN Y, ZHANG F. Risk factors for tigecycline-associated hypofibrinogenemia[J]. Ther Clin Risk Manag, 2021, 17: 325-332. DOI: 10.2147/TCRM.S302850.
    [26]
    ZHANG Q, WANG J, LIU H, et al. Risk factors for tigecycline-induced hypofibrinogenaemia[J]. J Clin Pharm Ther, 2020, 45(6): 1434-1441. DOI: 10.1111/jcpt.13250.
    [27]
    CAMPANY-HERRERO D, LARROSA-GARCIA M, LALUEZA-BROTO P, et al. Tigecycline-associated hypofibrinogenemia in a real-world setting[J]. Int J Clin Pharm, 2020, 42(4): 1184-1189. DOI: 10.1007/s11096-020-01072-7.
    [28]
    田佳, 梁大红, 马少欣, 等. 替加环素致低纤维蛋白原血症1例[J]. 中国临床药学杂志, 2021, 30(6): 469-472. DOI: 10.19577/j.1007-4406.2021.06.017.

    TIAN J, LIANG DH, MA SX, et al. A case of hypofibrinogenemia caused by tegacyclin[J]. Chin J Clin Pharm, 2021, 30(6): 469-472. DOI: 10.19577/j.1007-4406.2021.06.017.
    [29]
    LEI H, LIU X, LI Z, et al. Analysis of the clinical characteristics of tigecycline-induced hypofibrinogenemia[J]. J Chemother, 2022, DOI: 10.1080/1120009X.2022.2105488[Epubahead of print].
    [30]
    FAN Q, HUANG W, WENG Y, et al. Hypofibrinogenemia induced by high-dose tigecycline-case report and review of literature[J]. Medicine (Baltimore), 2020, 99(43): e22638. DOI: 10.1097/MD.0000000000022638.
    [31]
    XIE W, MA K, XU Z, et al. Risk factors of tigecycline-associated fibrinogen reduction in patients with renal transplantation: a case-control study[J]. Transl Androl Urol, 2022, 11(10): 1410-1418. DOI: 10.21037/tau-22-522.
    [32]
    李伟杰, 卢圆圆. 肾移植围术期替加环素致低纤维蛋白原血症1例及文献复习[J]. 亚太传统医药, 2020, 16(3): 157-159. DOI: 10.11954/ytctyy.202003051.

    LI WJ, LU YY. Tigecycline-induced Hypofibrinogenemia in a renal transplant patient: a case report and literature review[J]. Asia-Pacific Tradit Med, 2020, 16(3): 157-159. DOI: 10.11954/ytctyy.202003051.
    [33]
    TREML B, RAJSIC S, HELL T, et al. Progression of fibrinogen decrease during high dose tigecycline therapy in critically ill patients: a retrospective analysis[J]. J Clin Med, 2021, 10(20): 4702. DOI: 10.3390/jcm10204702.
    [34]
    ZHOU Y, XU P, LI H, et al. Population pharmacokinetics and exposure-response analysis of tigecycline in patients with hospital-acquired pneumonia[J]. Br J Clin Pharmacol, 2021, 87(7): 2838-2846. DOI: 10.1111/bcp.14692.
    [35]
    HU J, XIAO YH, ZHENG Y, et al. Clinical characteristics and risk factors of tigecycline-associated hypofibrinogenaemia in critically ill patients[J]. Eur J Clin Pharmacol, 2020, 76(7): 913-922. DOI: 10.1007/s00228-020-02860-w.
    [36]
    CHEN Z, SHI X. Adverse events of high-dose tigecycline in the treatment of ventilator-associated pneumonia due to multidrug-resistant pathogens[J]. Medicine (Baltimore), 2018, 97(38): e12467. DOI: 10.1097/MD.0000000000012467.
    [37]
    姚芬, 王曦培, 王依凡, 等. 高剂量替加环素治疗ICU患者肺部感染的临床疗效[J]. 今日药学, 2021, 31(6): 449-453. DOI: 10.12048/j.issn.1674-229X.2021.06.010.

    YAO F, WANG XP, WANG YF, et al, The clinical efficacy of high-dose tigecycline in ICU patients with pulmonary infections[J]. Pharm Today, 2021, 31(6): 449-453. DOI: 10.12048/j.issn.1674-229X.2021.06.010.
    [38]
    HAN H, QIN W, ZHENG Y, et al. High-dose versus standard-dose tigecycline treatment of secondary bloodstream infections caused by extensively drug-resistant acinetobacter baumannii: an observational cohort study[J]. Infect Drug Resist, 2021, 14: 3837-3848. DOI: 10.2147/IDR.S322803.
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