Clinical Outcome of Vancomycin-Resistant Enterococcus Colonization Among Liver Transplant Recipients at Shiraz Organ Transplant Center

Ejtehadi, Fardad; Zare, Ehsan; Shamsaeefar, Alireza; Nikeghbalian, Saman; Kazemi, Kourosh; Nikoupour, Hamed; Eghlimi, Hesameddin; Motazedian, Nasrin; Moghadami, Mohsen; Malekhosseini, Seyed Ali

doi:10.6002/ect.2020.0443

Cited by 3 publications

(2 citation statements)

References 34 publications

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“…Furthermore, screening for VRE colonization is not performed in our institution and could be a confounding factor because VRE colonization in liver transplant recipients is associated with greater morbidity 12 . Ejtehadi et al., however, found no adverse effect of asymptomatic VRE, though those patients were screened after transplantation 13 . Our institution performs a limited number of living donor transplantations, accounting for the small sample of living donor transplants in our cohort and limits the power of comparisons in that group.…”

Section: Discussionmentioning

confidence: 94%

“…12 Ejtehadi et al, however, found no adverse effect of asymptomatic VRE, though those patients were screened after transplantation. 13 Our institution performs a limited number of living donor transplantations, accounting for the small sample of living donor transplants in our cohort and limits the power of comparisons in that group. In attempting to capture the most relevant antibiotic exposures by limiting the definition to inpatient administration within a month preceding transplantation, the scope of exposure is likely underestimated.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology and outcomes associated with enterococcal blood stream infection among liver and kidney transplant recipients

He,

Naqvi,

Cowan

et al. 2024

Clinical Transplantation

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Bloodstream infections (BSIs) account for 18% of bacterial infections in the first year after solid organ transplantation (SOT). Enterococcus accounts for up to 20% of BSIs in this population, with vancomycin‐resistant enterococcus (VRE) posing a particular risk. This is a retrospective, case‐control study of adult liver and kidney transplant recipients between 01/01/2016 and 06/30/2021 that characterizes the epidemiology and outcomes of enterococcal BSIs in liver and kidney transplantations at a single institution. Subjects with an enterococcal BSI within the first 6 months post‐transplant were compared to those with non‐enterococcal BSIs in the same period. We identified 26 subjects with enterococcal BSIs and 28 controls with non‐enterococcal BSIs (n = 54; 10.3%). Cases were mostly liver transplant recipients (n = 20; 77%) with a median MELD at transplant of 33 (range 14–43); controls included 14 KT recipients (50%). Groups differed significantly (all p < .05) by factors including perioperative transfusion requirements, need for reoperation, and number of interventions post‐transplant. Cases had a median time of 25.5 days to infection and controls 100.5 days (p < .0001). There were no differences in 1‐year mortality between the groups. Enterococcus faecium was the predominant species of Enterococcus (n = 23; 88.5%), with a majority (91.3%) of the isolates being VRE. In our liver and kidney transplants, enterococcal BSIs occurred early among liver transplant recipients. The high incidence of VRE among E. faecium isolates in this population warrants further investigation into the optimal approach to empiric antimicrobials for bacteremia in the early post‐transplant period.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Epidemiology and outcomes associated with enterococcal blood stream infection among liver and kidney transplant recipients

He,

Naqvi,

Cowan

et al. 2024

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

The impact of colonization by multidrug resistant bacteria on graft survival, risk of infection, and mortality in recipients of solid organ transplant: systematic review and meta-analysis

Almohaya,

Fersovich,

Weyant

et al. 2024

Clinical Microbiology and Infection

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Epidemiology and Prevention of Early Infections by Multi-Drug-Resistant Organisms in Adults Undergoing Liver Transplant: A Narrative Review

et al. 2023

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Invasive bacterial infections are a leading cause of morbidity and mortality after liver transplant (LT), especially during the first months after LT, and infections due to multi-drug-resistant organisms (MDRO) are increasing in this setting. Most of the infections in patients in intensive care unit arise from the endogenous microflora and, for this reason, pre-LT MDRO rectal colonization is a risk factor for developing MDRO infections in the post-LT. Moreover, the transplanted liver may carry an increased risk of MDRO infections due to organ transportation and preservation, to donor intensive care unit stay and previous antibiotic exposure. To date, little evidence is available about how MDRO pre-LT colonization in donors and recipients should address LT preventive and antibiotic prophylactic strategies, in order to reduce MDRO infections in the post-LT period. The present review provided an extensive overview of the recent literature on these topics, with the aim to offer a comprehensive insight about the epidemiology of MDRO colonization and infections in adult LT recipients, donor-derived MDRO infections, possible surveillance, and prophylactic strategies to reduce post-LT MDRO infections.

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Clinical Outcome of Vancomycin-Resistant Enterococcus Colonization Among Liver Transplant Recipients at Shiraz Organ Transplant Center

Cited by 3 publications

References 34 publications

Epidemiology and outcomes associated with enterococcal blood stream infection among liver and kidney transplant recipients

Epidemiology and outcomes associated with enterococcal blood stream infection among liver and kidney transplant recipients

The impact of colonization by multidrug resistant bacteria on graft survival, risk of infection, and mortality in recipients of solid organ transplant: systematic review and meta-analysis

Epidemiology and Prevention of Early Infections by Multi-Drug-Resistant Organisms in Adults Undergoing Liver Transplant: A Narrative Review

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