Nosocomial Infection Among Patients Undergoing Liver Transplantation and Strategies for Prevention

Background: Morbidity and mortality due to infectious complications remain a major problem. Infection is the most frequent cause of death following liver transplantation. Infection accounts for more than one half of observed mortality associated with liver transplantation. The Aim: Of this study was to assess the risk factors for infection of pre-operative, operative and post operative patient undergoing liver transplantation and design a strategy for infection control protocol in liver transplant program in National Liver Institute, Menofia University. Material and Method: This study was conducted during the period started from the first of April 2008 to the end of Dec. 2008. Design: Descriptive design. Setting: This study was conducted in National Liver Institute, Menofia University. Sample: A purposive sample of 50 patients undergoing liver transplantation was selected to fulfill the following criteria; Male and female, Children and adults. Tools: (1) A structured Interview questionnaire for collecting socio-demographic data about the patient, past and Present medical history. (II) Biophysiologic measures; total Leukocyte Count, C-reactive protein, Swabs and Cultures. (III) Observation checklist. Results of the Present Study: • The incidence of infection was high among patients who had gastrointestinal tract bleeding and cholangitis preoperatively. • The infection was found among patients whose aseptic technique was poorly done operative and post operatively. Infection complicated 38 patients out of 50 transplanted patients (76% ). Conclusion: The present study concluded that the patients with elevated levels of preoperative C. reactive protein (C.R.P) and Total leukocytes count (TLC) were at risk to acquire infection. In addition prolonged operative time and non maintenance of aseptic technique of insertion and removing catheter was considered significant risk factors toward infection. Recommendation: In-services training program for Nurses, Health care workers and Patient s contacts. Suggestion for implementation of the proposed strategy of infection control protocol for liver transplantation.