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Published on: August 17, 2022
Acquisition of methicillin-resistant Staphylococcus aureus after living donor liver transplantation: a retrospective
Masao Hashimoto1, Yasuhiko Sugawara, Sumihito Tamura
1Artificial Organ and Transplantation Division, Department of Surgery, University of Tokyo, Tokyo, Japan. hashimom-tky@umin.ac.jp
Background:
The incidence and risk factors of methicillin-resistant Staphylococcus aureus (MRSA) acquisition after living donor liver transplantation (LDLT) are unclear. The aim of the present study was to assess the incidence and to analyze the risk factors for the acquisition of MRSA after LDLT in adults by multivariate analysis.
Methods:
We retrospectively reviewed the data from 158 adult patients that underwent LDLT at the Tokyo University Hospital. The microbiologic and medical records of the patients from admission to 3 months after LDLT were reviewed. Uni- and multivariate analyses were performed to identify the risk factors for postoperative acquisition of MRSA.
Results:
Postoperative MRSA acquisition was detected in 35 of 158 patients by median postoperative day 18. Age (>or= 60 y) and perioperative dialysis and/or apheresis predicted postoperative MRSA acquisition by multivariate analysis. In contrast, postoperative use of fluoroquinolone was negatively associated with acquisition of MRSA.
Conclusion:
MRSA arose early after LDLT in adults with a high incidence (35 of 158 patients). Surveillance culture should be checked periodically after LDLT to identify and prevent the transmission of MRSA.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) frequently occurs after adult living donor liver transplantation (LDLT). Older age and perioperative dialysis/apheresis increase MRSA risk, while fluoroquinolone use may decrease it.
Area of Science:
- Hepatology
- Infectious Diseases
- Transplantation Medicine
Background:
- The incidence and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition post-living donor liver transplantation (LDLT) remain largely unknown.
- Understanding these factors is crucial for preventing post-transplant infections.
Purpose of the Study:
- To determine the incidence of MRSA acquisition in adult LDLT recipients.
- To identify risk factors associated with MRSA acquisition after LDLT using multivariate analysis.
Main Methods:
- Retrospective review of 158 adult patients undergoing LDLT.
- Analysis of microbiologic and medical records from admission to 3 months post-LDLT.
- Uni- and multivariate analyses to identify risk factors for MRSA acquisition.
Main Results:
- MRSA was acquired by 35 out of 158 patients, with a median detection on postoperative day 18.
- Advanced age (≥60 years) and perioperative dialysis/apheresis were significant predictors of MRSA acquisition.
- Postoperative fluoroquinolone use showed a negative association with MRSA acquisition.
Conclusions:
- MRSA incidence is high and occurs early after adult LDLT.
- Periodic surveillance cultures are recommended post-LDLT to detect and prevent MRSA transmission.
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