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MRSA and VRE colonization in solid organ transplantation: a meta-analysis of published studies

P D Ziakas, E E Pliakos, F N Zervou

    American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
    |July 22, 2014
    PubMed

    Insights

    Solid organ transplant patients face high risks of MRSA and VRE colonization. This colonization significantly elevates the likelihood of developing these infections, necessitating enhanced prevention strategies.

    Area of Science:

    • Infectious Diseases
    • Transplantation Medicine
    • Microbiology

    Background:

    • Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE) pose significant threats in healthcare settings.
    • The prevalence and impact of MRSA and VRE colonization in solid organ transplant (SOT) recipients remain incompletely understood.

    Purpose of the Study:

    • To systematically evaluate the burden of MRSA and VRE colonization in SOT patients.
    • To determine the association between colonization status and the risk of subsequent MRSA or VRE infections.
    • To stratify colonization prevalence and infection risk in pre- and post-transplant periods.

    Main Methods:

    • A comprehensive literature search was conducted using PubMed and EMBASE databases.
    • A meta-analysis was performed to pool prevalence estimates of MRSA and VRE colonization.
    • The risk of infection associated with colonization was estimated using pooled risk ratios, stratified by transplant phase.

    Main Results:

    • Twenty-three studies met eligibility criteria, with 74% focusing on liver transplant recipients.
    • Pooled pre-transplant prevalence: MRSA 8.5%, VRE 11.9%. Pooled post-transplant prevalence: MRSA 9.4%, VRE 16.2%.
    • Both pre- and post-transplant MRSA/VRE colonization significantly increased the risk of respective infections (RR ranging from 5.51 to 10.56 for MRSA, and 6.65 to 7.93 for VRE).

    Conclusions:

    • Solid organ transplantation represents a high-risk scenario for MRSA and VRE colonization.
    • MRSA and VRE carrier status is a significant predictor of infection in SOT patients.
    • There is a critical need to enhance prevention and eradication strategies for MRSA and VRE in this vulnerable population.

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