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Related Experiment Videos

Vancomycin-resistant Enterococcus in liver transplant patients.

S L Orloff1, A M Busch, A J Olyaei

  • 1Department of Surgery, Oregon Health Sciences University and Portland Veterans Affairs Medical Center, USA.

American Journal of Surgery
|June 12, 1999
PubMed
Summary

Vancomycin-resistant Enterococcus (VRE) infection poses a severe threat to liver transplant recipients, with high mortality rates. Key patient characteristics include prior vancomycin use and coinfections, highlighting the need for strict infection control.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Transplant Surgery

Background:

  • Vancomycin-resistant Enterococcus (VRE) is an emerging pathogen in transplant recipients.
  • Effective antibiotic therapies for VRE are currently limited.
  • Liver transplant candidates and recipients are particularly vulnerable to VRE infection and colonization.

Purpose of the Study:

  • To investigate the outcomes of VRE infection and colonization in orthotopic liver transplant (OLTx) candidates.
  • To identify common characteristics associated with VRE infection and colonization in this population.

Main Methods:

  • Retrospective review of 126 VRE isolates from 47 OLTx candidates/recipients between October 1994 and September 1998.
  • Data collected via patient chart review and computerized hospital database.

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Main Results:

  • One-year mortality was 82% for VRE infection and 7% for VRE colonization, significantly higher than non-VRE transplant patients (14%).
  • Common VRE patient characteristics included prior vancomycin use (87%), coinfection (74%), prior enterococcal infection (72%), fungal infection (62%), and biliary complications (52%).
  • Renal failure and additional post-OLTx laparotomies were also noted in a significant proportion of VRE patients.

Conclusions:

  • VRE infection is associated with a very high mortality rate post-liver transplantation.
  • Biliary complications are frequently observed in VRE-infected or colonized patients.
  • Strict infection control measures and judicious vancomycin use are crucial due to the lack of effective antimicrobial therapies.