title: Hepatic iron content and the risk of Staphylococcus aureus bacteremia in liver transplant recipients.
abstract: 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.
authors.affiliation: Veterans Affairs Healthcare System, Pittsburgh, PA, USA.
authors.forename: Nina
authors.initials: N
authors.lastname: Singh
authors.forename: Cheryl
authors.initials: C
authors.lastname: Wannstedt
authors.forename: Lois
authors.initials: L
authors.lastname: Keyes
authors.forename: Debra
authors.initials: D
authors.lastname: Mayher
authors.forename: Lisa
authors.initials: L
authors.lastname: Tickerhoof
authors.forename: Mohamed
authors.initials: M
authors.lastname: Akoad
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Wagener
authors.forename: Roy
authors.initials: R
authors.lastname: Frye
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Cacciarelli
mesh_terms: 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*