title: Methicillin-resistant Staphylococcus aureus infection after living-donor liver transplantation in adults.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) infection frequently complicates the postoperative course in deceased-donor liver transplantation. The incidence and risk factors of MRSA infection after Living-donor Liver transplantation (LDLT), however, are unclear.
  
  
  METHODS
  We retrospectively reviewed the data from 242 adult patients who underwent LDLT at the University of Tokyo 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 independent risk factors for postoperative MRSA infection.
  
  
  RESULTS
  Postoperative MRSA infection occurred in 25 of 242 patients by median postoperative day 23. Preoperative MRSA colonization, preoperative use of antimicrobials, operation time (> or =16 h), and postoperative apheresis independently predicted postoperative MRSA infection.
  
  
  CONCLUSIONS
  Surveillance culture should be checked periodically after admission to identify patients at high risk for MRSA infection and to administer appropriate antimicrobials for perioperative infection. Postoperative apheresis, suggesting postoperative liver dysfunction, predisposed patients to MRSA infection.
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, University of Tokyo, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Y
authors.initials: Y
authors.lastname: Sugawara
authors.forename: S
authors.initials: S
authors.lastname: Tamura
authors.forename: J
authors.initials: J
authors.lastname: Kaneko
authors.forename: Y
authors.initials: Y
authors.lastname: Matsui
authors.forename: K
authors.initials: K
authors.lastname: Moriya
authors.forename: K
authors.initials: K
authors.lastname: Koike
authors.forename: M
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents