Infectious Diseases Section, University of Nebraska Medical Center, Omaha, USA.
Infection. 2012 Jun;40(3):263-9. doi: 10.1007/s15010-011-0224-3. Epub 2011 Nov 29.
More data on the risk factors and outcomes after Staphylococcus aureus infections in liver transplantation are needed.
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.
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.
Only recent surgical procedure was found to be a significant independent risk factor for S. aureus infections after liver transplantation.
需要更多关于金黄色葡萄球菌感染在肝移植后风险因素和结果的数据。
回顾性确定金黄色葡萄球菌感染（病例）的肝移植受者，并与性别、年龄和移植类型匹配（1:2）的非金黄色葡萄球菌感染对照进行比较。通过条件逻辑回归分析确定与金黄色葡萄球菌感染相关的危险因素。
我们评估了 51 名患者（中位年龄 52 岁）。首次金黄色葡萄球菌感染发生在移植后 29 天的中位数时间，其中 52.94%发生在第一个月；88.24%为医院获得性感染，41.18%为多微生物感染，47.06%由耐甲氧西林金黄色葡萄球菌（MRSA）引起。手术部位感染占 58.82%，菌血症占 23.53%。单因素分析显示，金黄色葡萄球菌感染患者插管更频繁（比值比 [OR] 26.92，95%置信区间 [CI] 3.23-3,504.15，p = 0.0006），有中央导管（OR 11.69，95% CI 1.42-95.9，p = 0.02）或近期手术（OR 26.92，95% CI 3.23-3,504.15，p = 0.0006）与对照组相比。多因素分析显示，感染前 2 周内接受手术的患者金黄色葡萄球菌感染的风险增加 26.9 倍（95% CI 3.23-3,504.15，p = 0.0006）；这些结果针对匹配标准进行了调整。金黄色葡萄球菌感染不会影响移植物或患者的存活率，但本研究没有针对这些结果进行统计效力分析。
只有最近的手术程序被发现是肝移植后金黄色葡萄球菌感染的一个显著独立危险因素。
