Methicillin-resistant Staphylococcus aureus infection in liver transplantation: a matched controlled study.
The purpose of this study was to evaluate the clinical impact of methicillin-resistant Staphylococcus aureus (MRSA) infections on transplant recipients.


METHODS
Liver and kidney recipients with MRSA infections were retrospectively identified and compared to an age, gender, UNOS status, organ transplanted, and transplant date matched (2:1) non-MRSA-infected recipient control group. All MRSA infections were initially treated with vancomycin, and four (33%) liver recipients were converted to linezolid therapy after failing to improve with vancomycin.


RESULTS
The overall MRSA infection incidence was 1.4% (24/1770) with MRSA more common in liver (3.75%; 12/320) than kidney transplants (0.8%; 12/1450) (P < .001). The most common sites of MRSA infection were blood (42%), lung (38%), and abdomen (29%). The MRSA group had a greater percentage of prior antibiotic usage (79% vs 40%; P < .0015). The MRSA group experienced more posttransplant complications (52% vs 19%; P < .011)), and exhibited a trend toward greater length of stay in the intensive care unit (7.8 vs 4.6 days; P = .09), but not overall length of stay. Survival was similar in MRSA and non-MRSA groups (75% vs 88%; P = .17). No significant differences in mortality were noted between liver and kidney recipients infected with MRSA (P = .6).


CONCLUSIONS
MRSA infection is associated with a higher incidence of posttransplant complications and antibiotic usage in both liver and kidney recipients compared to patients with MRSA infection.
Schneider
C R
CR
Division of Transplantation University of Cincinnati, Cincinnati, Ohio 45249, USA.
Buell
J F
JF
Gearhart
M
M
Thomas
M
M
Hanaway
M J
MJ
Rudich
S M
SM
Woodle
E S
ES
D000081:Acetamides / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D000069349:Linezolid; D016031:Liver Transplantation; D008297:Male; D016106:Methicillin Resistance; D023303:Oxazolidinones / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D016019:Survival Analysis; D014640:Vancomycin / Q000627:therapeutic use
D000081:Acetamides; D023303:Oxazolidinones; D014640:Vancomycin; D000069349:Linezolid