Clinical significance of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci colonization in liver transplant recipients
The Korean Journal of Internal Medicine
; : 694-704, 2015.
Article
de En
| WPRIM
| ID: wpr-76674
Bibliothèque responsable:
WPRO
ABSTRACT
BACKGROUND/AIMS: Liver transplant patients are at high risk for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) colonization. We evaluated patients before and after liver transplant using active surveillance culture (ASC) to assess the prevalence of MRSA and VRE and to determine the effect of bacterial colonization on patient outcome. METHODS: We performed ASC on 162 liver transplant recipients at the time of transplantation and 7 days posttransplantation to monitor the prevalence of MRSA and VRE. RESULTS: A total of 142 patients had both nasal and rectal ASCs. Of these patients, MRSA was isolated from 12 (7.4%) at the time of transplantation (group 1a), 9 (6.9%) acquired MRSA posttransplantation (group 2a), and 121 did not test positive for MRSA at either time (group 3a). Among the three groups, group 1a patients had the highest frequency of developing a MRSA infection (p < 0.01); however, group 2a patients had the highest mortality rate associated with MRSA infection (p = 0.05). Of the 142 patients, VRE colonization was detected in 37 patients (22.8%) at the time of transplantation (group 1b), 21 patients (20%) acquired VRE posttransplantation (group 2b), and 84 patients did not test positive for VRE at either time (group 3b). Among these three groups, group 2b patients had the highest frequency of VRE infections (p < 0.01) and mortality (p = 0.04). CONCLUSIONS: Patients that acquired VRE or MRSA posttransplantation had higher mortality rates than did those who were colonized pre-transplantation or those who never acquired the pathogens. Our findings highlight the importance of preventing the acquisition of MRSA and VRE posttransplantation to reduce infections and mortality among liver transplant recipients.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Infections à staphylocoques
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Facteurs temps
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Prévalence
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Études prospectives
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Facteurs de risque
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Transplantation hépatique
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Résultat thérapeutique
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Infections bactériennes à Gram positif
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Enterococcus
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Résistance à la vancomycine
Type d'étude:
Etiology_studies
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
Limites du sujet:
Adult
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Female
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Humans
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Male
Pays comme sujet:
Asia
langue:
En
Texte intégral:
The Korean Journal of Internal Medicine
Année:
2015
Type:
Article