Zhou Jiandang, Huang Hui, Liu Shan, Yu Ping, Wan Qiquan
Department of Clinical Laboratory, the Third Xiangya Hospital of Central South University, People's Republic of China ; Department of Immunology, Xiangya School of Medicine, Central South University, People's Republic of China.
Nursing Department, the Third Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.
Ther Clin Risk Manag. 2015 Jun 12;11:933-7. doi: 10.2147/TCRM.S84579. eCollection 2015.
To describe the incidence, clinical characteristics, and outcomes of Staphylococcus aureus bacteremia after liver transplantation and investigate the drug resistance of S. aureus to frequently used antibiotics to provide evidence for clinical prevention and therapy.
In a double-center retrospective study, blood cultures positive for S. aureus were obtained from January 1, 2001 to December 31, 2014. The BACTEC 9120 blood culture system and the Vitek-2 system were used to process blood samples and identify species, respectively. We also collected these patients' data to confirm clinical and laboratory characteristics.
Twenty of 275 (7.3%) liver recipients developed S. aureus bacteremia during the study period. The median time to the onset of S. aureus bacteremias was 6 days after liver transplantation and all episodes of bacteremias were early onset. The lung was the most common source of primary infection, followed by the intra-abdominal/biliary tract. A total of nine (45%) liver recipients died due to S. aureus bacteremias. Of these 20 S. aureus cases, 80% were methicillin-resistant. S. aureus was highly resistant to erythromycin and penicillin (resistance rate >90%). No S. aureus resistant to glycopeptides and oxazolidone antibiotics was observed. There were seven (35%) liver recipients with an inappropriate antibiotic therapy. Between the periods of 2001-2007 and 2008-2014, the distribution of methicillin-resistant S. aureus was not significantly different (P=1.000). Pneumonia as a predominant primary source, a high body temperature, abnormal blood pressure, and decreased platelets, which occurred in the early period after liver transplantation, as well as high morbidity and mortality, were the main characteristics of S. aureus bacteremias.
S. aureus led to severe bacteremias in liver recipients, with high morbidity and mortality, and the majority of them comprised methicillin-resistant S. aureus.
描述肝移植后金黄色葡萄球菌血症的发病率、临床特征及转归，并研究金黄色葡萄球菌对常用抗生素的耐药性，为临床预防和治疗提供依据。
在一项双中心回顾性研究中，收集2001年1月1日至2014年12月31日期间血培养金黄色葡萄球菌阳性的病例。分别采用BACTEC 9120血培养系统和Vitek-2系统处理血样并鉴定菌种。我们还收集了这些患者的数据以确定临床和实验室特征。
275例肝移植受者中有20例（7.3%）在研究期间发生金黄色葡萄球菌血症。金黄色葡萄球菌血症发病的中位时间为肝移植后6天，所有菌血症发作均为早期发作。肺部是最常见的原发性感染源，其次是腹腔/胆道。共有9例（45%）肝移植受者死于金黄色葡萄球菌血症。在这20例金黄色葡萄球菌病例中，80%为耐甲氧西林金黄色葡萄球菌。金黄色葡萄球菌对红霉素和青霉素高度耐药（耐药率>90%）。未观察到对糖肽类和恶唑烷酮类抗生素耐药的金黄色葡萄球菌。有7例（35%）肝移植受者接受了不恰当的抗生素治疗。在2001 - 2007年和2008 - 2014年期间，耐甲氧西林金黄色葡萄球菌的分布无显著差异（P = 1.000）。肺炎作为主要的原发性感染源、高热、血压异常、血小板减少，这些在肝移植后早期出现的情况，以及高发病率和高死亡率，是金黄色葡萄球菌血症的主要特征。
金黄色葡萄球菌导致肝移植受者发生严重菌血症，发病率和死亡率高，且大多数为耐甲氧西林金黄色葡萄球菌。
