Hepatic iron content and the risk of Staphylococcus aureus bacteremia in liver transplant recipients.
Iron is a critical nutrient source and contributes to staphylococcal pathogenesis. We assessed the role of hepatic explant iron overload as a risk factor for Staphylococcus aureus bacteremia in liver transplant recipients. Seven of 13 cases with S aureus bacteremia (53.8%) had hepatic explant iron concentrations that exceeded normal limits (grade > or = 2). Length of posttransplant intensive care unit stay (P= .013) and hepatocellular carcinoma as underlying liver disease (P = .04), but not hepatic explant iron concentration, correlated with a higher risk of S aureus bacteremia after transplantation. However, noncarriers (patients without S aureus nasal carriage) who developed S aureus bacteremia were more likely to have high hepatic iron content; 4 of 7 (57%) noncarriers with high-grade iron content developed S aureus bacteremia but no noncarriers with low-grade iron content did (P = .07). All noncarriers who became infected had high iron content (grade > or = 2) of the hepatic explant. A readily quantifiable assessment of hepatic iron at the time of transplantation can potentially identify patients without carriage who may be at risk for early S aureus bacteremia.
Singh
Nina
N
Veterans Affairs Healthcare System, Pittsburgh, PA, USA.
Wannstedt
Cheryl
C
Keyes
Lois
L
Mayher
Debra
D
Tickerhoof
Lisa
L
Akoad
Mohamed
M
Wagener
Marilyn M
MM
Frye
Roy
R
Cacciarelli
Thomas V
TV
D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000209:etiology*; D006801:Humans; D019190:Iron Overload / Q000382:microbiology*; D008099:Liver / Q000378:metabolism*; D016031:Liver Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000209:etiology*