Hashimoto Masao, Sugawara Yasuhiko, Tamura Sumihito, Kaneko Junichi, Matsui Yuichi, Togashi Junichi, Moriya Kyoji, Koike Kazuhiko, Makuuchi Masatoshi
Artificial Organ and Transplantation Division, Department of Surgery, University of Tokyo, Tokyo, Japan.
BMC Infect Dis. 2008 Nov 11;8:155. doi: 10.1186/1471-2334-8-155.
The incidence and risk factors of methicillin-resistant Staphylococcus aureus (MRSA) acquisition after living donor liver transplantation (LDLT) are unclear. The aim of the present study was to assess the incidence and to analyze the risk factors for the acquisition of MRSA after LDLT in adults by multivariate analysis.
We retrospectively reviewed the data from 158 adult patients that underwent LDLT at the Tokyo University Hospital. The microbiologic and medical records of the patients from admission to 3 months after LDLT were reviewed. Uni- and multivariate analyses were performed to identify the risk factors for postoperative acquisition of MRSA.
Postoperative MRSA acquisition was detected in 35 of 158 patients by median postoperative day 18. Age (>or= 60 y) and perioperative dialysis and/or apheresis predicted postoperative MRSA acquisition by multivariate analysis. In contrast, postoperative use of fluoroquinolone was negatively associated with acquisition of MRSA.
MRSA arose early after LDLT in adults with a high incidence (35 of 158 patients). Surveillance culture should be checked periodically after LDLT to identify and prevent the transmission of MRSA.
活体肝移植（LDLT）后耐甲氧西林金黄色葡萄球菌（MRSA）感染的发生率及危险因素尚不清楚。本研究旨在评估成人LDLT后MRSA感染的发生率，并通过多因素分析来分析其危险因素。
我们回顾性分析了东京大学医院158例接受LDLT的成年患者的数据。对患者从入院到LDLT后3个月的微生物学和医疗记录进行了回顾。进行单因素和多因素分析以确定术后获得MRSA的危险因素。
158例患者中有35例在术后第18天（中位数）检测到术后MRSA感染。多因素分析显示，年龄（≥60岁）、围手术期透析和/或血液滤过可预测术后MRSA感染。相比之下，术后使用氟喹诺酮与MRSA感染呈负相关。
成人LDLT后MRSA感染发生率较高（158例患者中有35例），且出现较早。LDLT后应定期进行监测培养，以识别和预防MRSA的传播。
