Staphylococcus aureus infections after liver transplantation

Diana F Florescu, A. M. McCartney, F. Qiu, Alan Norman Langnas, J. Botha, David F Mercer, W. Grant, Andre C Kalil

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: More data on the risk factors and outcomes after Staphylococcus aureus infections in liver transplantation are needed. Methods: Liver recipients with S. aureus infections (cases) were retrospectively identified and compared to gender-, age-, and transplant type-matched (1:2) non-S. aureusinfected controls. Risk factors associated with S. aureus infections were identified by conditional logistic regression analysis. Results:: We evaluated 51 patients (median age 52 years). First S. aureus infections developed at a median time of 29 days after transplantation, with 52.94% of them in the first month; 88.24% were nosocomial, 41.18% were polymicrobial, and 47.06% were caused by methicillinresistant S. aureus (MRSA). Surgical site infections represented 58.82% and bacteremia 23.53%. By univariate analysis, patients with S. aureus infections were intubated more frequently (odds ratio [OR] 26.92, 95% confidence interval [CI] 3.23-3,504.15, p = 0.0006), had a central line (OR 11.69, 95% CI 1.42-95.9, p = 0.02), or recent surgery (OR 26.92, 95% CI 3.23-3,504.15, p = 0.0006) compared with controls. By multivariate analysis, subjects who underwent surgery within 2 weeks prior to infection had a 26.9 times higher risk of developing S. aureus infection (95% CI 3.23-3,504.15, p = 0.0006); these results were adjusted for matched criteria. S. aureus infections did not affect graft or patient survival, but the study was not powered for such outcomes. Conclusion: Only recent surgical procedure was found to be a significant independent risk factor for S. aureus infections after liver transplantation.

Original languageEnglish (US)
Pages (from-to)263-269
Number of pages7
JournalInfection
Volume40
Issue number3
DOIs
StatePublished - Jun 1 2012

Fingerprint

Liver Transplantation
Staphylococcus aureus
Infection
Confidence Intervals
Odds Ratio
Transplants
Surgical Wound Infection
Bacteremia
Multivariate Analysis
Transplantation
Logistic Models
Regression Analysis
Survival
Liver

Keywords

  • Infection
  • Liver transplantation
  • Outcome
  • Risk factors
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Staphylococcus aureus infections after liver transplantation. / Florescu, Diana F; McCartney, A. M.; Qiu, F.; Langnas, Alan Norman; Botha, J.; Mercer, David F; Grant, W.; Kalil, Andre C.

In: Infection, Vol. 40, No. 3, 01.06.2012, p. 263-269.

Research output: Contribution to journalArticle

Florescu, Diana F ; McCartney, A. M. ; Qiu, F. ; Langnas, Alan Norman ; Botha, J. ; Mercer, David F ; Grant, W. ; Kalil, Andre C. / Staphylococcus aureus infections after liver transplantation. In: Infection. 2012 ; Vol. 40, No. 3. pp. 263-269.
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abstract = "Background: More data on the risk factors and outcomes after Staphylococcus aureus infections in liver transplantation are needed. Methods: Liver recipients with S. aureus infections (cases) were retrospectively identified and compared to gender-, age-, and transplant type-matched (1:2) non-S. aureusinfected controls. Risk factors associated with S. aureus infections were identified by conditional logistic regression analysis. Results:: We evaluated 51 patients (median age 52 years). First S. aureus infections developed at a median time of 29 days after transplantation, with 52.94{\%} of them in the first month; 88.24{\%} were nosocomial, 41.18{\%} were polymicrobial, and 47.06{\%} were caused by methicillinresistant S. aureus (MRSA). Surgical site infections represented 58.82{\%} and bacteremia 23.53{\%}. By univariate analysis, patients with S. aureus infections were intubated more frequently (odds ratio [OR] 26.92, 95{\%} confidence interval [CI] 3.23-3,504.15, p = 0.0006), had a central line (OR 11.69, 95{\%} CI 1.42-95.9, p = 0.02), or recent surgery (OR 26.92, 95{\%} CI 3.23-3,504.15, p = 0.0006) compared with controls. By multivariate analysis, subjects who underwent surgery within 2 weeks prior to infection had a 26.9 times higher risk of developing S. aureus infection (95{\%} CI 3.23-3,504.15, p = 0.0006); these results were adjusted for matched criteria. S. aureus infections did not affect graft or patient survival, but the study was not powered for such outcomes. Conclusion: Only recent surgical procedure was found to be a significant independent risk factor for S. aureus infections after liver transplantation.",
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AU - Florescu, Diana F

AU - McCartney, A. M.

AU - Qiu, F.

AU - Langnas, Alan Norman

AU - Botha, J.

AU - Mercer, David F

AU - Grant, W.

AU - Kalil, Andre C

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N2 - Background: More data on the risk factors and outcomes after Staphylococcus aureus infections in liver transplantation are needed. Methods: Liver recipients with S. aureus infections (cases) were retrospectively identified and compared to gender-, age-, and transplant type-matched (1:2) non-S. aureusinfected controls. Risk factors associated with S. aureus infections were identified by conditional logistic regression analysis. Results:: We evaluated 51 patients (median age 52 years). First S. aureus infections developed at a median time of 29 days after transplantation, with 52.94% of them in the first month; 88.24% were nosocomial, 41.18% were polymicrobial, and 47.06% were caused by methicillinresistant S. aureus (MRSA). Surgical site infections represented 58.82% and bacteremia 23.53%. By univariate analysis, patients with S. aureus infections were intubated more frequently (odds ratio [OR] 26.92, 95% confidence interval [CI] 3.23-3,504.15, p = 0.0006), had a central line (OR 11.69, 95% CI 1.42-95.9, p = 0.02), or recent surgery (OR 26.92, 95% CI 3.23-3,504.15, p = 0.0006) compared with controls. By multivariate analysis, subjects who underwent surgery within 2 weeks prior to infection had a 26.9 times higher risk of developing S. aureus infection (95% CI 3.23-3,504.15, p = 0.0006); these results were adjusted for matched criteria. S. aureus infections did not affect graft or patient survival, but the study was not powered for such outcomes. Conclusion: Only recent surgical procedure was found to be a significant independent risk factor for S. aureus infections after liver transplantation.

AB - Background: More data on the risk factors and outcomes after Staphylococcus aureus infections in liver transplantation are needed. Methods: Liver recipients with S. aureus infections (cases) were retrospectively identified and compared to gender-, age-, and transplant type-matched (1:2) non-S. aureusinfected controls. Risk factors associated with S. aureus infections were identified by conditional logistic regression analysis. Results:: We evaluated 51 patients (median age 52 years). First S. aureus infections developed at a median time of 29 days after transplantation, with 52.94% of them in the first month; 88.24% were nosocomial, 41.18% were polymicrobial, and 47.06% were caused by methicillinresistant S. aureus (MRSA). Surgical site infections represented 58.82% and bacteremia 23.53%. By univariate analysis, patients with S. aureus infections were intubated more frequently (odds ratio [OR] 26.92, 95% confidence interval [CI] 3.23-3,504.15, p = 0.0006), had a central line (OR 11.69, 95% CI 1.42-95.9, p = 0.02), or recent surgery (OR 26.92, 95% CI 3.23-3,504.15, p = 0.0006) compared with controls. By multivariate analysis, subjects who underwent surgery within 2 weeks prior to infection had a 26.9 times higher risk of developing S. aureus infection (95% CI 3.23-3,504.15, p = 0.0006); these results were adjusted for matched criteria. S. aureus infections did not affect graft or patient survival, but the study was not powered for such outcomes. Conclusion: Only recent surgical procedure was found to be a significant independent risk factor for S. aureus infections after liver transplantation.

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KW - Liver transplantation

KW - Outcome

KW - Risk factors

KW - Staphylococcus aureus

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