Journal Article

Methicillin-Resistant <i>Staphylococcus aureus:</i> The Other Emerging Resistant Gram-Positive Coccus among Liver Transplant Recipients

Nina Singh, David L. Paterson, Feng Yee Chang, Timothy Gayowski, Cheryl Squier, Marilyn M. Wagener and Ignazio R. Marino

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 30, issue 2, pages 322-327
Published in print February 2000 | ISSN: 1058-4838
Published online February 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313658
Methicillin-Resistant Staphylococcus aureus: The Other Emerging Resistant Gram-Positive Coccus among Liver Transplant Recipients

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We undertook a study of the characteristics and clinical impact of infections due to methicillin-resistant Staphylococcus aureus (MRSA) after liver transplantation. Of 165 patients who received liver transplants at our institution from 1990 through 1998, 38 (23%) developed MRSA infections. The predominant sources of infection were vascular catheters (39%; n = 15), wound (18%; n = 7), abdomen (18%; n = 7), and lung (13%; n = 5). A significant increase in MRSA infections (as a percentage of transplant patients infected per year) occurred over time (P =.0001). This increase was greater among intensive care unit patients (P =.001) than among nonintensive care unit hospital patients (P=.17). Cytomegalovirus seronegativity (P =.01) and primary cytomegalovirus infection were significantly associated with MRSA infections (P =.005). Thirty-day mortality among patients with MRSA infections was 21% (8/38). Mortality was 86% in patients with bacteremic MRSA pneumonia or abdominal infection and 6% in those with catheter-related bacteremia (P =.004). Thus the incidence of MRSA infection has increased exponentially among our liver transplant recipients since 1990. These infections have unique risk factors, time of onset, and a significant difference in site-specific mortality; deep-seated bacteremic infections, in particular, portend a grave outcome.

Journal Article.  3909 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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