Risk factors and outcomes of staphylococcus aureus infections after small bowel and multivisceral transplantation

Diana F. Florescu, Fang Qiu, Renuga Vivekanandan, David F. Mercer, Alan N. Langnas, Andre C. Kalil

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: No studies have evaluated the risk factors and outcomes of Staphylococcus aureus (SA) infections in small bowel (SBT) and multivisceral (including small bowel) transplantation (MVT). Methods: SBT and MVT recipients with SA infections (22 cases) were retrospectively identified and compared with matched non-SA-infected recipient controls (44). The characteristics were compared with Friedman and Cochran-Mantel-Haenszel tests. Conditional logistic regression analysis was performed to identify risk factors, and Kaplan-Meier curve and Cox proportional hazard model were performed for survival analysis. Results: The median age was 2.07 years (range, 0.76-54.04). Forty-three percent of the first SA infections were bloodstream infections, 30% lung infections, and 26% surgical site infections; 36% of these isolates were methicillin-resistant SA. Median time (days) to surgical site infections (41.0; range, 0-89) was significantly shorter than that to lung infections (266; range, 130-378) (P = 0.01). By univariate analysis, it was found that cases were more likely to have cytomegalovirus (CMV) sero-mismatch (odds ratio [OR] = 3.03 [95% confidence interval, 0.88-10.43]; P = 0.08), and controls were more likely to receive mycophenolate mofetil (MMF) treatment (0.09 [0.001-0.82]; P = 0.03). By multivariable analysis, patients with CMV sero-mismatch were found to have higher odds of developing SA infection (OR, 2.92; P = 0.085), whereas MMF had a protective effect (OR, 0.08; P = 0.031), adjusting for matched criteria. SA cases had shorter survival than controls (mean survival, 28.5 vs. 45.8 months [P = 0.04]) and were 2.18 times more likely to die (1.02-4.67, P = 0.04). Conclusions: SA infections were associated with a significant shorter survival time and higher risk of death. The presence of CMV sero-mismatch and the absence of MMF treatment were found to be the risk factors for SA infections after SBT and MVT.

Original languageEnglish (US)
Pages (from-to)25-29
Number of pages5
JournalPediatric Infectious Disease Journal
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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