Impact of new methicillin-resistant Staphylococcus aureus carriage postoperatively after living donor liver transplantation.
BACKGROUND
Preoperative carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with an increased risk of MRSA infection after liver transplantation. It is not known, however, whether new MRSA carriage postoperatively also increases the risk of MRSA infection after liver transplantation.


METHODS
We retrospectively reviewed the data from 242 adult patients who underwent living donor liver transplantation (LDLT) including microbiological and medical records from admission to 3 months after LDLT. Uni and multivariate analyses were performed to identify independent risk factors for postoperative MRSA infection among preoperative noncarriers of MRSA.


RESULTS
Postoperative MRSA infection occurred in 18 of 219 preoperative noncarriers of MRSA by median postoperative day 26. Operation time of at least 16 hours and postoperative colonization with MRSA independently predicted postoperative MRSA infection.


CONCLUSIONS
Postoperative surveillance cultures should be performed periodically after liver transplantation to identify high-risk candidates for postoperative MRSA infection, even among preoperative noncarriers of MRSA.
Hashimoto
M
M
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Sugawara
Y
Y
Tamura
S
S
Kaneko
J
J
Matsui
Y
Y
Moriya
K
K
Koike
K
K
Makuuchi
M
M
D000328:Adult; D000368:Aged; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology; D018579:Patient Selection; D011183:Postoperative Complications / Q000382:microbiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects*