Colonisation with methicillin-resistant Staphylococcus aureus prior to renal transplantation is associated with long-term renal allograft failure.
Renal transplant recipients are at an increased risk of developing Methicillin-resistant Staphylococcus aureus due to their immunosuppressed status. Herein, we investigate the incidence of MRSA infection in patients undergoing renal transplantation and determine the effect of MRSA colonisation on renal allograft function and overall mortality. Between January 1st 2007 and December 31st 2012, 1499 consecutive kidney transplants performed in our transplant unit and a retrospective 1:2 matched case-control study was performed on this patient cohort. The 1-, 3- and 5-year overall graft survival rates were 100%, 86% and 78%, respectively, in MRSA positive recipients compared with 100%, 100% and 93%, respectively, in the control group (P < 0.05). The 1-, 3- and 5-year overall patient survival rates were 100%, 97% and 79%, respectively, in MRSA positive recipients compared with 100%, 100% and 95%, respectively, in the control group (P = 0.1). In a multiple logistic regression analysis, colonisation with MRSA pre-operatively was an independent predictor for renal allograft failure at 5 years (hazard ratio: 4.6, 95% confidence interval: 1-30.7, P = 0.048). These findings demonstrate that the incidence of long-term renal allograft failure is significantly greater in this patient cohort compared with a matched control population.
Department of Urology and Transplant Surgery, Beaumont Hospital, Dublin, Ireland.
Carmel
C
Moore
Niall F
NF
Davis
John P
JP
Burke
Richard
R
Power
Ponnusamy
P
Mohan
David
D
Hickey
Gordon
G
Smyth
Molly
M
Eng
Dilly M
DM
Little
D000293:Adolescent; D000328:Adult; D016470:Bacteremia / Q000453:epidemiology*; D002353:Carrier State / Q000188:drug therapy / Q000453:epidemiology*; D016022:Case-Control Studies; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003428:Cross Infection / Q000382:microbiology / Q000401:mortality; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000502:physiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011300:Preoperative Care; D051437:Renal Insufficiency / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
D007166:Immunosuppressive Agents
immunosuppression; kidney transplant; methicillin-resistant Staphylococcus aureus; transplantation