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Impact of new methicillin-resistant Staphylococcus aureus carriage postoperatively after living donor liver

M Hashimoto1, Y Sugawara, S Tamura

  • 1Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

Transplantation Proceedings
|December 20, 2007
PubMed
Abstract

Insights

New methicillin-resistant Staphylococcus aureus (MRSA) carriage after liver transplantation increases infection risk. Postoperative surveillance is crucial for identifying high-risk patients, even those initially MRSA-negative.

Area of Science:

  • Infectious Diseases
  • Transplantation Surgery
  • Microbiology

Background:

  • Preoperative methicillin-resistant Staphylococcus aureus (MRSA) carriage is a known risk factor for post-liver transplant infection.
  • The impact of *new* postoperative MRSA carriage on infection risk after liver transplantation remains unclear.

Purpose of the Study:

  • To investigate whether new methicillin-resistant Staphylococcus aureus (MRSA) carriage acquired postoperatively increases the risk of MRSA infection in liver transplant recipients.
  • To identify independent risk factors for postoperative MRSA infection in patients who were not carriers before surgery.

Main Methods:

  • Retrospective review of 242 adult patients undergoing living donor liver transplantation (LDLT).
  • Analysis of microbiological and medical records from admission up to 3 months post-LDLT.
  • Univariate and multivariate analyses to determine independent risk factors for postoperative MRSA infection in preoperative non-carriers.

Main Results:

  • Postoperative MRSA infection developed in 18 of 219 preoperative non-carriers by a median of postoperative day 26.
  • Independent predictors for postoperative MRSA infection included operation time of at least 16 hours and postoperative colonization with MRSA.

Conclusions:

  • Postoperative colonization with methicillin-resistant Staphylococcus aureus (MRSA) is an independent risk factor for infection after liver transplantation.
  • Periodic postoperative surveillance cultures are recommended to identify patients at high risk for MRSA infection, including those initially MRSA-negative.

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