Staphylococcus aureus infections after liver transplantation.

Abstract

BACKGROUND:

More data on the risk factors and outcomes after Staphylococcus aureus infections in liver transplantation are needed.

METHODS:

Liver recipients with S. aureus infections (cases) were retrospectively identified and compared to gender-, age-, and transplant type-matched (1:2) non-S. aureus-infected controls. Risk factors associated with S. aureus infections were identified by conditional logistic regression analysis.

RESULTS:

We evaluated 51 patients (median age 52 years). First S. aureus infections developed at a median time of 29 days after transplantation, with 52.94% of them in the first month; 88.24% were nosocomial, 41.18% were polymicrobial, and 47.06% were caused by methicillin-resistant S. aureus (MRSA). Surgical site infections represented 58.82% and bacteremia 23.53%. By univariate analysis, patients with S. aureus infections were intubated more frequently (odds ratio [OR] 26.92, 95% confidence interval [CI] 3.23-3,504.15, p = 0.0006), had a central line (OR 11.69, 95% CI 1.42-95.9, p = 0.02), or recent surgery (OR 26.92, 95% CI 3.23-3,504.15, p = 0.0006) compared with controls. By multivariate analysis, subjects who underwent surgery within 2 weeks prior to infection had a 26.9 times higher risk of developing S. aureus infection (95% CI 3.23-3,504.15, p = 0.0006); these results were adjusted for matched criteria. S. aureus infections did not affect graft or patient survival, but the study was not powered for such outcomes.

CONCLUSION:

Only recent surgical procedure was found to be a significant independent risk factor for S. aureus infections after liver transplantation.

• Authors: D F Florescu, A M McCartney, F Qiu, A N Langnas, J Botha, D F Mercer, W Grant, A C Kalil
• Journal: Infection (Infection) Vol. 40 Issue 3 Pg. 263-9 (Jun 2012) ISSN: 1439-0973 [Electronic] Germany
• PMID: 22124952 (Publication Type: Journal Article)

Chemical References

• Immunosuppressive Agents
• Steroids

Topics

• Adolescent
• Bacteremia (epidemiology, microbiology)
• Case-Control Studies
• Child
• Cross Infection (epidemiology, microbiology)
• Female
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects)
• Liver Transplantation (adverse effects)
• Logistic Models
• Male
• Methicillin-Resistant Staphylococcus aureus (isolation & purification)
• Middle Aged
• Multivariate Analysis
• Nebraska
• Postoperative Complications (epidemiology, mortality)
• Retrospective Studies
• Risk Factors
• Staphylococcal Infections (epidemiology, mortality)
• Staphylococcus aureus (isolation & purification)
• Steroids (administration & dosage, adverse effects)
• Survival Analysis
• Time Factors