title: Staphylococcus aureus infections after liver transplantation.
abstract: BACKGROUND
  More data on the risk factors and outcomes after Staphylococcus aureus infections in liver transplantation are needed.
  
  
  METHODS
  Liver recipients with S. aureus infections (cases) were retrospectively identified and compared to gender-, age-, and transplant type-matched (1:2) non-S. aureus-infected controls. Risk factors associated with S. aureus infections were identified by conditional logistic regression analysis.
  
  
  RESULTS
  We evaluated 51 patients (median age 52 years). First S. aureus infections developed at a median time of 29 days after transplantation, with 52.94% of them in the first month; 88.24% were nosocomial, 41.18% were polymicrobial, and 47.06% were caused by methicillin-resistant S. aureus (MRSA). Surgical site infections represented 58.82% and bacteremia 23.53%. By univariate analysis, patients with S. aureus infections were intubated more frequently (odds ratio [OR] 26.92, 95% confidence interval [CI] 3.23-3,504.15, p = 0.0006), had a central line (OR 11.69, 95% CI 1.42-95.9, p = 0.02), or recent surgery (OR 26.92, 95% CI 3.23-3,504.15, p = 0.0006) compared with controls. By multivariate analysis, subjects who underwent surgery within 2 weeks prior to infection had a 26.9 times higher risk of developing S. aureus infection (95% CI 3.23-3,504.15, p = 0.0006); these results were adjusted for matched criteria. S. aureus infections did not affect graft or patient survival, but the study was not powered for such outcomes.
  
  
  CONCLUSIONS
  Only recent surgical procedure was found to be a significant independent risk factor for S. aureus infections after liver transplantation.
authors: Infectious Diseases Section, University of Nebraska Medical Center, Omaha, USA. dflorescu@unmc.edu
authors: D F
authors: DF
authors: Florescu
authors: A M
authors: AM
authors: McCartney
authors: F
authors: F
authors: Qiu
authors: A N
authors: AN
authors: Langnas
authors: J
authors: J
authors: Botha
authors: D F
authors: DF
authors: Mercer
authors: W
authors: W
authors: Grant
authors: A C
authors: AC
authors: Kalil
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D016022:Case-Control Studies; D002648:Child; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D015999:Multivariate Analysis; D009329:Nebraska; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000401:mortality; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids