Vancomycin-resistant Enterococcus in liver transplant patients

• Published in: The American journal of surgery 1999-05, Vol.177 (5), p.418-422
• Main Authors: Orloff, Susan L., Busch, Ann M.H., Olyaei, Ali J., Corless, Christopher L., Benner, Kent G., Flora, Ken D., Rosen, Hugo R., Rabkin, John M.
• Format: Article
• Language: English
• Subjects: Adult; Anti-Bacterial Agents - pharmacology; Antibiotic resistance; Antibiotics; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biliary Tract Diseases - etiology; Biological and medical sciences; Campylobacter; Colonization; Complications; Dialysis; Drug Resistance, Microbial; Enterococcus; Enterococcus - drug effects; Enterococcus - pathogenicity; Female; Fungal infections; Fungi; Gram-Positive Bacterial Infections - complications; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - mortality; Hepatitis C; Hospitals; Human bacterial diseases; Humans; Infection Control; Infectious diseases; Length of stay; Liver; Liver cirrhosis; Liver transplantation; Liver Transplantation - adverse effects; Liver transplants; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical sciences; Microorganisms; Middle Aged; Mortality; Multidrug resistant organisms; Nosocomial infections; Pathogens; Patients; Prognosis; Renal failure; Retrospective Studies; Risk Assessment; Sepsis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surveillance; Transplantation; Vancomycin; Vancomycin - pharmacology
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(99)00083-5

BACKGROUND: Vancomycin-resistant Enterococcus (VRE) infection is emerging in the transplant population, and there is no effective antibiotic therapy available. The aims of this retrospective review were to (1) investigate the outcome of and (2) identify common characteristics associated with VRE infection and colonization in orthotopic liver transplant (OLTx) candidates. METHODS: From October 1994 through September 1998, 126 isolates of VRE were identified in 42 of 234 OLTx recipients and 5 OLTx candidates who did not proceed to transplantation. Data were collected by patient chart review or from a computerized hospital database. RESULTS: The 1-year mortality rate with VRE infection was 82%, and with VRE colonization, 7%. This mortality rate contrasts with a 14% 1-year mortality for non-VRE transplant patients ( P 2.5 mg/dL or need for dialysis; 43%). Biliary complications were seen in 52% of post-OLTx VRE-infected or VRE-colonized patients (versus 22% in non-VRE transplant patients, P