Obstacles in infection management following living donor liver transplantation (LDLT) are majorly precipitated by device-associated infections (DAIs), which significantly increase morbidity rates. In a bid to curb this detrimental health effect, it becomes crucial to examine the potential of different care routines, such as the bundled care approach, in reducing DAI rates. A comparative study was undertaken over a three-year period (2016-2018) at a liver transplantation facility to assess the efficacy of implementing a care bundle, comprising several evidence-proven procedures employed as a unified unit.
The study, featuring 57 LDLT patients, was segmented into three distinctive phases. In the baseline phase, the rates of pneumonia related to ventilators (VAP), bloodstream infections linked to central lines (CLABSI), and catheter-associated urinary tract infections (CAUTI) were considerably high. However, subsequent implementation of bundled care led to a remarkable reduction in these rates during the second phase, and the improvement was sustained in the follow-up phase. Bacterial identification and antibiotic susceptibility testing were performed using the automated Vitek-2 system, and the differences across phases were evaluated using statistical measures.
Given that infections can drastically affect the function and long-term survival of a transplanted liver, concerted efforts must be made in optimizing infection prevention and management strategies. Emphasis is thus placed on consistent implementation of care bundle methods to enhance patient outcomes and reduce DAI rates, as well as the consequent economic burden of prolonged hospital stays, intensive care utilization, and the potential for graft failure and re-transplantation.
Still, it’s worth noting that this study was confined to a liver transplantation facility over a limited period. Therefore, further research across diverse clinical settings and over extended periods would be instrumental in affirming the comprehensive applicability of bundled care approaches in infection prevention.
Source: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09525-4