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Published on: March 8, 2024
Methicillin-resistant Staphylococcus aureus infection in liver transplantation: a matched controlled study
C R Schneider1, J F Buell, M Gearhart
1Division of Transplantation University of Cincinnati, Cincinnati, Ohio 45249, USA.
Unlabelled:
The purpose of this study was to evaluate the clinical impact of methicillin-resistant Staphylococcus aureus (MRSA) infections on transplant recipients.
Methods:
Liver and kidney recipients with MRSA infections were retrospectively identified and compared to an age, gender, UNOS status, organ transplanted, and transplant date matched (2:1) non-MRSA-infected recipient control group. All MRSA infections were initially treated with vancomycin, and four (33%) liver recipients were converted to linezolid therapy after failing to improve with vancomycin.
Results:
The overall MRSA infection incidence was 1.4% (24/1770) with MRSA more common in liver (3.75%; 12/320) than kidney transplants (0.8%; 12/1450) (P < .001). The most common sites of MRSA infection were blood (42%), lung (38%), and abdomen (29%). The MRSA group had a greater percentage of prior antibiotic usage (79% vs 40%; P < .0015). The MRSA group experienced more posttransplant complications (52% vs 19%; P < .011)), and exhibited a trend toward greater length of stay in the intensive care unit (7.8 vs 4.6 days; P = .09), but not overall length of stay. Survival was similar in MRSA and non-MRSA groups (75% vs 88%; P = .17). No significant differences in mortality were noted between liver and kidney recipients infected with MRSA (P = .6).
Conclusion:
MRSA infection is associated with a higher incidence of posttransplant complications and antibiotic usage in both liver and kidney recipients compared to patients with MRSA infection.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) infections in transplant recipients are linked to more complications and antibiotic use. However, survival rates were similar between MRSA-infected and non-infected patients.
Area of Science:
- Transplant medicine
- Infectious diseases
- Clinical microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
- Transplant recipients are particularly vulnerable to infections due to immunosuppression.
Purpose of the Study:
- To assess the clinical impact of MRSA infections in liver and kidney transplant recipients.
- To compare outcomes between MRSA-infected and non-MRSA-infected transplant patients.
Main Methods:
- Retrospective analysis of liver and kidney transplant recipients with MRSA infections.
- Matched control group of non-MRSA-infected recipients (2:1 ratio).
- Comparison of post-transplant complications, antibiotic usage, and survival rates.
Main Results:
- MRSA infections were more common in liver (3.75%) than kidney (0.8%) transplant recipients.
- MRSA group showed higher rates of prior antibiotic use (79%) and post-transplant complications (52%).
- No significant difference in overall survival or mortality between MRSA-infected and control groups.
Conclusions:
- MRSA infection in transplant recipients is associated with increased post-transplant complications.
- Higher prior antibiotic usage is noted in patients with MRSA infections.
- Despite complications, MRSA infection did not significantly impact overall survival in this cohort.
