The outcomes of methicillin-resistant Staphylococcus aureus infection after living donor liver transplantation in a Japanese center.
OBJECTIVE
The objective of this study is to present results from our review of methicillin-resistant Staphylococcus aureus (MRSA) infection in living-donor liver transplant (LDLT) recipients.


METHODS
Seventy patients with primary LDLT between August 1997 and May 2007 were retrospectively reviewed.


RESULTS
Overall, 9 patients (12.9%) encountered various kinds of MRSA infection after transplantation [peritonitis (6), bacteremia (6), pneumonia (3), wound infection (3), cholangitis (1)]; 4 of these 9 patients died. Of these 4 expired patients, 3 were highly urgent cases with very poor pretransplant status under ventilator support. In one patient, linezolid was effective after teicoplanin failure for severe systemic MRSA infections (bacteremia, peritonitis, cholangitis, pneumonia, and enteritis). Of the 4 patients in whom MRSA was isolated only in a nasal swab before transplantation, none developed MRSA infection after transplantation with a 3-day course of mupirocin prophylaxis.


CONCLUSIONS
MRSA infection was a contributing factor in death after transplantation in cases with poor pretransplant status. Linezolid was effective even for treating systemic MRSA infection after LDLT. A short course of mupirocin prophylaxis seemed to be effective and did not have any adverse effects.
Takatsuki
Mitsuhisa
M
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. takapon@net.nagasaki-u.ac.jp
Eguchi
Susumu
S
Yamanouchi
Kosho
K
Hidaka
Masaaki
M
Soyama
Akihiko
A
Miyazaki
Kensuke
K
Tajima
Yoshitsugu
Y
Kanematsu
Takashi
T
D000081:Acetamides / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D000069349:Linezolid; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D023303:Oxazolidinones / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D055815:Young Adult
D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D000069349:Linezolid