Methicillin-resistant Staphylococcus aureus: The other emerging resistant gram-positive coccus among liver transplant recipients

Singh, Nina, Paterson, David L., Chang, Feng Yee, Gayowski, Timothy, Squier, Cheryl, Wagener, Marilyn M. and Marino, Ignazio R. (2000) Methicillin-resistant Staphylococcus aureus: The other emerging resistant gram-positive coccus among liver transplant recipients. Clinical Infectious Diseases, 30 2: 322-327. doi:10.1086/313658


Author Singh, Nina
Paterson, David L.
Chang, Feng Yee
Gayowski, Timothy
Squier, Cheryl
Wagener, Marilyn M.
Marino, Ignazio R.
Title Methicillin-resistant Staphylococcus aureus: The other emerging resistant gram-positive coccus among liver transplant recipients
Journal name Clinical Infectious Diseases   Check publisher's open access policy
ISSN 1058-4838
Publication date 2000-02
Sub-type Article (original research)
DOI 10.1086/313658
Volume 30
Issue 2
Start page 322
End page 327
Total pages 4
Place of publication Chicago Ill., U.S.A.
Publisher University of Chicago Press
Language eng
Subject 1103 Clinical Sciences
1117 Public Health and Health Services
Abstract We undertook a study of the characteristics and clinical impact of infections due to methicillin-resistant Staphylococcus aureus (MRSA) after liver transplantation. Of 165 patients who received liver transplants at our institution from 1990 through 1998, 38 (23%) developed MRSA infections. The predominant sources of infection were vascular catheters (39%; n = 15), wound (18%; n = 7), abdomen (18%; n = 7), and lung (13%; n = 5). A significant increase in MRSA infections (as a percentage of transplant patients infected per year) occurred over time (P = .0001). This increase was greater among intensive care unit patients (P = .001) than among nonintensive care unit hospital patients (P= .17). Cytomegalovirus seronegativity (P = .01) and primary cytomegalovirus infection were significantly associated with MRSA infections (P = .005). Thirty-day mortality among patients with MRSA infections was 21% (8/38). Mortality was 86% in patients with bacteremic MRSA pneumonia or abdominal infection and 6% in those with catheter-related bacteremia (P = .004). Thus the incidence of MRSA infection has increased exponentially among our liver transplant recipients since 1990. These infections have unique risk factors, time of onset, and a significant difference in site-specific mortality; deep-seated bacteremic infections, in particular, portend a grave outcome.
Keyword Nosocomial Infections
Enterococcus-faecium
Vancomycin
Bacteremia
Rifampin
Risk
Cytomegalovirus
Colonization
Acquisition
Mortality
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: UQ Centre for Clinical Research Publications
 
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Created: Tue, 07 Sep 2010, 17:12:19 EST