Skip to main content
Top
Published in: BMC Infectious Diseases 1/2008

Open Access 01-12-2008 | Research article

Acquisition of methicillin-resistant Staphylococcus aureus after living donor liver transplantation: a retrospective cohort study

Authors: Masao Hashimoto, Yasuhiko Sugawara, Sumihito Tamura, Junichi Kaneko, Yuichi Matsui, Junichi Togashi, Kyoji Moriya, Kazuhiko Koike, Masatoshi Makuuchi

Published in: BMC Infectious Diseases | Issue 1/2008

Login to get access

Abstract

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 (>= 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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Singh N, Paterson DL, Chang FY, Gayowski T, Squier C, Wagener MM, Marino IR: Methicillin-resistant Staphylococcus aureus: The other emerging resistant gram-positive coccus among liver transplant recipients. Clin Infect Dis. 2000, 30: 322-327. 10.1086/313658.CrossRefPubMed Singh N, Paterson DL, Chang FY, Gayowski T, Squier C, Wagener MM, Marino IR: Methicillin-resistant Staphylococcus aureus: The other emerging resistant gram-positive coccus among liver transplant recipients. Clin Infect Dis. 2000, 30: 322-327. 10.1086/313658.CrossRefPubMed
2.
go back to reference Singh N, Gayowski T, Rihs JD, Wagener MM, Marino IR: Evolving trends in multiple-antibiotic-resistant bacteria in liver transplant recipients: A longitudinal study of antimicrobial susceptibility patterns. Liver transpl. 2001, 7: 22-26. 10.1053/jlts.2001.20769.CrossRefPubMed Singh N, Gayowski T, Rihs JD, Wagener MM, Marino IR: Evolving trends in multiple-antibiotic-resistant bacteria in liver transplant recipients: A longitudinal study of antimicrobial susceptibility patterns. Liver transpl. 2001, 7: 22-26. 10.1053/jlts.2001.20769.CrossRefPubMed
3.
go back to reference Bert F, Galdbart JO, Zarrouk V, Le Mee J, Durand F, Mentre F, Belghiti J, Lambert-Zechovsky N, Fantin B: Association between nasal carriage of Staphylococcus aureus and infection in liver transplant recipients. Clin Infect Dis. 2000, 31: 1295-1299. 10.1086/317469.CrossRefPubMed Bert F, Galdbart JO, Zarrouk V, Le Mee J, Durand F, Mentre F, Belghiti J, Lambert-Zechovsky N, Fantin B: Association between nasal carriage of Staphylococcus aureus and infection in liver transplant recipients. Clin Infect Dis. 2000, 31: 1295-1299. 10.1086/317469.CrossRefPubMed
4.
go back to reference Chang FY, Singh N, Gayowski T, Drenning SD, Wagener MM, Marino IR: Staphylococcus aureus nasal colonization and association with infections in liver transplant recipients. Transplantation. 1998, 65: 1169-1172. 10.1097/00007890-199805150-00004.CrossRefPubMed Chang FY, Singh N, Gayowski T, Drenning SD, Wagener MM, Marino IR: Staphylococcus aureus nasal colonization and association with infections in liver transplant recipients. Transplantation. 1998, 65: 1169-1172. 10.1097/00007890-199805150-00004.CrossRefPubMed
5.
go back to reference Desai D, Desai N, Nightingale P, Elliott T, Neuberger J: Carriage of methicillin-resistant Staphylococcus aureus is associated with an increased risk of infection after liver transplantation. Liver Transpl. 2003, 9: 754-759. 10.1053/jlts.2003.50142.CrossRefPubMed Desai D, Desai N, Nightingale P, Elliott T, Neuberger J: Carriage of methicillin-resistant Staphylococcus aureus is associated with an increased risk of infection after liver transplantation. Liver Transpl. 2003, 9: 754-759. 10.1053/jlts.2003.50142.CrossRefPubMed
6.
go back to reference Davis KA, Stewart JJ, Crouch HK, Florez CE, Hospenthal DR: Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection. Clin Infect Dis. 2004, 39: 776-782. 10.1086/422997.CrossRefPubMed Davis KA, Stewart JJ, Crouch HK, Florez CE, Hospenthal DR: Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection. Clin Infect Dis. 2004, 39: 776-782. 10.1086/422997.CrossRefPubMed
7.
go back to reference Santoro-Lopes G, de Gouvea EF, Monteiro RC, Branco RC, Rocco JR, Halpern M, Ferreira AL, de Araujo EG, Basto ST, Silveria VG, Ribeiro-Filho J: Colonization with methicillin-resistant Staphylococcus aureus after liver transplantation. Liver Transpl. 2005, 11: 203-209. 10.1002/lt.20338.CrossRefPubMed Santoro-Lopes G, de Gouvea EF, Monteiro RC, Branco RC, Rocco JR, Halpern M, Ferreira AL, de Araujo EG, Basto ST, Silveria VG, Ribeiro-Filho J: Colonization with methicillin-resistant Staphylococcus aureus after liver transplantation. Liver Transpl. 2005, 11: 203-209. 10.1002/lt.20338.CrossRefPubMed
8.
go back to reference Urata K, Kawasaki S, Matsunami H, Hashikura Y, Ikegami T, Ishizone S, Momose Y, Komiyama A, Makuuchi M: Calculation of child and adult standard liver volume for liver transplantation. Hepatology. 1995, 21: 1317-1321.CrossRefPubMed Urata K, Kawasaki S, Matsunami H, Hashikura Y, Ikegami T, Ishizone S, Momose Y, Komiyama A, Makuuchi M: Calculation of child and adult standard liver volume for liver transplantation. Hepatology. 1995, 21: 1317-1321.CrossRefPubMed
9.
go back to reference Kokudo N, Sugawara Y, Imamura H, Sano K, Makuuchi M: Tailoring the type of donor hepatectomy for adult living donor liver transplantation. Am J Transpl. 2005, 5: 1694-1703. 10.1111/j.1600-6143.2005.00917.x.CrossRef Kokudo N, Sugawara Y, Imamura H, Sano K, Makuuchi M: Tailoring the type of donor hepatectomy for adult living donor liver transplantation. Am J Transpl. 2005, 5: 1694-1703. 10.1111/j.1600-6143.2005.00917.x.CrossRef
10.
go back to reference Sugawara Y, Makuuchi M: Technical advancement in living-related liver transplantation. J Hepatobiliary Pancreat Surg. 1999, 6: 245-253. 10.1007/s005340050114.CrossRefPubMed Sugawara Y, Makuuchi M: Technical advancement in living-related liver transplantation. J Hepatobiliary Pancreat Surg. 1999, 6: 245-253. 10.1007/s005340050114.CrossRefPubMed
11.
go back to reference Sugawara Y, Makuuchi M, Kaneko J, Ohkubo T, Imamura H, Kawarasaki H: Correlation between optimal tacrolimus doses and the graft weight in living donor liver transplantation. Clin Transplant. 2002, 16: 102-106. 10.1034/j.1399-0012.2002.1o106.x.CrossRefPubMed Sugawara Y, Makuuchi M, Kaneko J, Ohkubo T, Imamura H, Kawarasaki H: Correlation between optimal tacrolimus doses and the graft weight in living donor liver transplantation. Clin Transplant. 2002, 16: 102-106. 10.1034/j.1399-0012.2002.1o106.x.CrossRefPubMed
12.
go back to reference Clinical and Laboratory Standards Institute: M100-S17. Performance standards for antimicrobial susceptibility testing; 17th informational supplement. Clinical and Laboratory Standards Institute. Wayne, PA. 2007 Clinical and Laboratory Standards Institute: M100-S17. Performance standards for antimicrobial susceptibility testing; 17th informational supplement. Clinical and Laboratory Standards Institute. Wayne, PA. 2007
13.
go back to reference Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM: CDC definitions for nosocomial infections. Am J Infect Control. 1988, 16: 128-140. 10.1016/0196-6553(88)90053-3.CrossRefPubMed Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM: CDC definitions for nosocomial infections. Am J Infect Control. 1988, 16: 128-140. 10.1016/0196-6553(88)90053-3.CrossRefPubMed
14.
go back to reference Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG: CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definition of surgical wound infections. Infect Control Hosp Epidemiol. 1992, 13: 606-608.CrossRefPubMed Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG: CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definition of surgical wound infections. Infect Control Hosp Epidemiol. 1992, 13: 606-608.CrossRefPubMed
15.
go back to reference Singh N, Squier C, Wannstedt C, Keyes L, Wagener MM, Cacciarelli TV: Impact of an aggressive infection control strategy on endemic Staphylococcus aureus infection in liver transplant recipients. Infect Control Hosp Epidemiol. 2006, 27: 122-126. 10.1086/500651.CrossRefPubMed Singh N, Squier C, Wannstedt C, Keyes L, Wagener MM, Cacciarelli TV: Impact of an aggressive infection control strategy on endemic Staphylococcus aureus infection in liver transplant recipients. Infect Control Hosp Epidemiol. 2006, 27: 122-126. 10.1086/500651.CrossRefPubMed
16.
17.
go back to reference Muto CA, Jernigan JA, Ostrowsky BE, Richert HM, Jarvis WR, Boyce JM, Farr BM: SHEA Guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Infect Control Hosp Epidemiol. 2003, 24: 362-386. 10.1086/502213.CrossRefPubMed Muto CA, Jernigan JA, Ostrowsky BE, Richert HM, Jarvis WR, Boyce JM, Farr BM: SHEA Guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Infect Control Hosp Epidemiol. 2003, 24: 362-386. 10.1086/502213.CrossRefPubMed
18.
go back to reference Tomic V, Svetina Sorli P, Trinkaus D, Sorli J, Widmer A, Trampuz A: Comprehensive strategy to prevent nosocomial spread of methicillin-resistant Staphylococcus aureus in a highly endemic setting. Arch Intern Med. 2004, 164: 2038-2043. 10.1001/archinte.164.18.2038.CrossRefPubMed Tomic V, Svetina Sorli P, Trinkaus D, Sorli J, Widmer A, Trampuz A: Comprehensive strategy to prevent nosocomial spread of methicillin-resistant Staphylococcus aureus in a highly endemic setting. Arch Intern Med. 2004, 164: 2038-2043. 10.1001/archinte.164.18.2038.CrossRefPubMed
19.
go back to reference Asensio A, Guerrero A, Quereda C, Lizan M, Martinez-Ferrer M: Colonization and infection with methicillin-resistant Staphylococcus aureus: associated factors and eradication. Infect Control Hosp Epidemiol. 1996, 17: 20-28.CrossRefPubMed Asensio A, Guerrero A, Quereda C, Lizan M, Martinez-Ferrer M: Colonization and infection with methicillin-resistant Staphylococcus aureus: associated factors and eradication. Infect Control Hosp Epidemiol. 1996, 17: 20-28.CrossRefPubMed
20.
go back to reference Lucet JC, Paoletti X, Lolom I, Paugam-Burtz C, Trouillet JL, Timsit JF, Deblangy C, Andremont A, Regnier B: Successful long-term program for controlling methicillin-resistant Staphylococcus aureus in intensive care units. Intensive Care Med. 2005, 31: 1051-1057. 10.1007/s00134-005-2679-0.CrossRefPubMed Lucet JC, Paoletti X, Lolom I, Paugam-Burtz C, Trouillet JL, Timsit JF, Deblangy C, Andremont A, Regnier B: Successful long-term program for controlling methicillin-resistant Staphylococcus aureus in intensive care units. Intensive Care Med. 2005, 31: 1051-1057. 10.1007/s00134-005-2679-0.CrossRefPubMed
21.
go back to reference Dziekan G, Hahn A, Thune K, Schwarzer G, Schafer K, Daschner FD, Grundmann H: Methicillin-resistant Staphylococcus aureus in a teaching hospital: investigation of nosocomial transmission using a matched case-control study. J Hosp Infect. 2000, 46: 263-270. 10.1053/jhin.2000.0846.CrossRefPubMed Dziekan G, Hahn A, Thune K, Schwarzer G, Schafer K, Daschner FD, Grundmann H: Methicillin-resistant Staphylococcus aureus in a teaching hospital: investigation of nosocomial transmission using a matched case-control study. J Hosp Infect. 2000, 46: 263-270. 10.1053/jhin.2000.0846.CrossRefPubMed
22.
go back to reference Boyce JM: Understanding and controlling methicillin-resistant Staphylococcus aureus infections. Infect Control Hosp Epidemiol. 2002, 23: 485-487. 10.1086/502092.CrossRefPubMed Boyce JM: Understanding and controlling methicillin-resistant Staphylococcus aureus infections. Infect Control Hosp Epidemiol. 2002, 23: 485-487. 10.1086/502092.CrossRefPubMed
23.
go back to reference Crossley K, Landesman B, Zaske D: An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. II. Epidemiologic studies. J Infect Dis. 1979, 139: 280-CrossRefPubMed Crossley K, Landesman B, Zaske D: An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. II. Epidemiologic studies. J Infect Dis. 1979, 139: 280-CrossRefPubMed
24.
go back to reference Peacock JE, Marsik FJ, Wenzel RP: Methicillin-resistant Staphylococcus aureus: introduction and spread within a hospital. Ann Intern Med. 1980, 93: 526-532.CrossRefPubMed Peacock JE, Marsik FJ, Wenzel RP: Methicillin-resistant Staphylococcus aureus: introduction and spread within a hospital. Ann Intern Med. 1980, 93: 526-532.CrossRefPubMed
25.
go back to reference Hershow RC, Khayr WF, Smith NL: A comparison of clinical virulence of nosocomially acquired methicillin-resistant and methicillin-sensitive Staphylococcus aureus infections in a university hospital. Infect Control Hosp Epidemiol. 1992, 13: 587-593.CrossRefPubMed Hershow RC, Khayr WF, Smith NL: A comparison of clinical virulence of nosocomially acquired methicillin-resistant and methicillin-sensitive Staphylococcus aureus infections in a university hospital. Infect Control Hosp Epidemiol. 1992, 13: 587-593.CrossRefPubMed
26.
go back to reference French GL, Cheng AF, Ling JM, Mo P, Donnan S: Hong Kong strains of methicillin-resistant and methicillin-sensitive Staphylococcus aureus have similar virulence. J Hosp Infect. 1990, 15: 117-125. 10.1016/0195-6701(90)90120-D.CrossRefPubMed French GL, Cheng AF, Ling JM, Mo P, Donnan S: Hong Kong strains of methicillin-resistant and methicillin-sensitive Staphylococcus aureus have similar virulence. J Hosp Infect. 1990, 15: 117-125. 10.1016/0195-6701(90)90120-D.CrossRefPubMed
27.
go back to reference Marshall C, Wolfe R, Kossmann T, Wesselingh S, Harrington G, Spelman D: Risk factors for acquisition of methicillin-resistant Staphylococcus aureus (MRSA) by trauma patients in the intensive care unit. J Hosp Infect. 2004, 57: 245-252. 10.1016/j.jhin.2004.03.024.CrossRefPubMed Marshall C, Wolfe R, Kossmann T, Wesselingh S, Harrington G, Spelman D: Risk factors for acquisition of methicillin-resistant Staphylococcus aureus (MRSA) by trauma patients in the intensive care unit. J Hosp Infect. 2004, 57: 245-252. 10.1016/j.jhin.2004.03.024.CrossRefPubMed
28.
go back to reference Colleo R, Glynn JR, Gaspar C, Picazo JJ, Feres J: Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA. J Hosp Infect. 1997, 37: 39-46. 10.1016/S0195-6701(97)90071-2.CrossRef Colleo R, Glynn JR, Gaspar C, Picazo JJ, Feres J: Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA. J Hosp Infect. 1997, 37: 39-46. 10.1016/S0195-6701(97)90071-2.CrossRef
29.
go back to reference Topeli A, Unal S, Akalin HE: Risk factors influencing clinical outcome in Staphylococcus aureus bacteraemia in a Turkish University Hospital. Int J Antimicrob Agents. 2000, 14: 57-63. 10.1016/S0924-8579(99)00147-8.CrossRefPubMed Topeli A, Unal S, Akalin HE: Risk factors influencing clinical outcome in Staphylococcus aureus bacteraemia in a Turkish University Hospital. Int J Antimicrob Agents. 2000, 14: 57-63. 10.1016/S0924-8579(99)00147-8.CrossRefPubMed
30.
go back to reference Graffunder EM, Venezia RA: Risk factors associated with nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection including previous use of antimicrobials. J Antimicrob Chemother. 2002, 49: 999-1005. 10.1093/jac/dkf009.CrossRefPubMed Graffunder EM, Venezia RA: Risk factors associated with nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection including previous use of antimicrobials. J Antimicrob Chemother. 2002, 49: 999-1005. 10.1093/jac/dkf009.CrossRefPubMed
31.
go back to reference Weber SG, Gold HS, Hooper DC, Karchmer AW, Carmeli Y: Fluoroquinolones and the risk for methicillin-resistant Staphylococcus aureus in hospitalized patients. Emerg Infect Dis. 2003, 9: 1415-1422.CrossRefPubMedPubMedCentral Weber SG, Gold HS, Hooper DC, Karchmer AW, Carmeli Y: Fluoroquinolones and the risk for methicillin-resistant Staphylococcus aureus in hospitalized patients. Emerg Infect Dis. 2003, 9: 1415-1422.CrossRefPubMedPubMedCentral
32.
go back to reference Onorato M, Borucki MJ, Baillargeon G, Paar DP, Freeman DH, Cole CP, Mayhall CG: Risk factors for colonization or infection due to methicillin-resistant Staphylococcus aureus in HIV-positive patients: a retrospective case-control study. Infect Control Hosp Epidemiol. 1999, 20: 26-30. 10.1086/501556.CrossRefPubMed Onorato M, Borucki MJ, Baillargeon G, Paar DP, Freeman DH, Cole CP, Mayhall CG: Risk factors for colonization or infection due to methicillin-resistant Staphylococcus aureus in HIV-positive patients: a retrospective case-control study. Infect Control Hosp Epidemiol. 1999, 20: 26-30. 10.1086/501556.CrossRefPubMed
33.
go back to reference Crowcroft NS, Ronveaux O, Monnet DL, Mertens R: Methicillin-resistant Staphylococcus aureus and antimicrobial use in Belgian hospitals. Infect Control Hosp Epidemiol. 1999, 20: 31-36. 10.1086/501555.CrossRefPubMed Crowcroft NS, Ronveaux O, Monnet DL, Mertens R: Methicillin-resistant Staphylococcus aureus and antimicrobial use in Belgian hospitals. Infect Control Hosp Epidemiol. 1999, 20: 31-36. 10.1086/501555.CrossRefPubMed
34.
go back to reference Singh N, Gayowski T, Wagener MM, Marino IR: Bloodstream infections in liver transplant recipients receiving tacrolimus. Clin Transpl. 1997, 11: 275-281. Singh N, Gayowski T, Wagener MM, Marino IR: Bloodstream infections in liver transplant recipients receiving tacrolimus. Clin Transpl. 1997, 11: 275-281.
35.
go back to reference Kluytmans J, van Belkum A, Verbrugh H: Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev. 1997, 10: 505-520.PubMedPubMedCentral Kluytmans J, van Belkum A, Verbrugh H: Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev. 1997, 10: 505-520.PubMedPubMedCentral
36.
go back to reference Nouwen JL, Fieren MW, Snijders S, Verbrugh HA, Belkum A: Persistent (not intermittent) nasal carriage of Staphylococcus aureus is the determinant of CPD-related infections. Kidney Int. 2005, 67: 1084-1092. 10.1111/j.1523-1755.2005.00174.x.CrossRefPubMed Nouwen JL, Fieren MW, Snijders S, Verbrugh HA, Belkum A: Persistent (not intermittent) nasal carriage of Staphylococcus aureus is the determinant of CPD-related infections. Kidney Int. 2005, 67: 1084-1092. 10.1111/j.1523-1755.2005.00174.x.CrossRefPubMed
Metadata
Title
Acquisition of methicillin-resistant Staphylococcus aureus after living donor liver transplantation: a retrospective cohort study
Authors
Masao Hashimoto
Yasuhiko Sugawara
Sumihito Tamura
Junichi Kaneko
Yuichi Matsui
Junichi Togashi
Kyoji Moriya
Kazuhiko Koike
Masatoshi Makuuchi
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2008
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-8-155

Other articles of this Issue 1/2008

BMC Infectious Diseases 1/2008 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.