Methicillin-resistant Staphylococcus aureus bacteremia among liver transplant recipients: epidemiology and associated risk factors for morbidity and mortality

Abstract

Taohua Liu,1 Yuezhong Zhang,1 Qiquan Wan2 1Department of Clinical Medicine, Xiangya School of Medicine, Central South University, Changsha, People’s Republic of China; 2Department of Transplant Surgery, the Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China Abstract: Bacteremia due to Staphylococcus aureus, especially methicillin-resistant S. aureus (MRSA), complicates the clinical course of liver transplantation and is associated with high morbidity and mortality. Intravascular catheters had been reported to be the most frequent source of MRSA bacteremia. Among bacteremic liver recipients, 26.3%–100% of S. aureus were MRSA. Previous studies identified pre-transplant and post-transplant acquired S. aureus carriage, greater severity of liver disease, hepatocellular carcinoma and infection with immunomodulatory viruses as predictors of S. aureus bacteremia in liver recipients. MRSA bacteremia accompanied by pneumonia and abdominal infections was related to mortality. Vancomycin, as well as daptomycin, is a first-line antibiotic for MRSA bacteremia. The purpose of this review is to better understand the characteristics of MRSA bacteremia by summarizing the epidemiology and antimicrobial resistance of S. aureus, the primary source, and related risk factors for morbidity and mortality of MRSA bacteremia. We have also explored the diagnostic, therapeutic and preventive measures for MRSA bacteremia to improve the outcomes of liver recipients. Keywords: methicillin-resistant Staphylococcus aureus, bacteremia, risk factors, morbidity, mortality, liver transplantation

Keywords

• Methicillin-resistant Staphylococcus aureus
• bacteremia
• risk factors
• morbidity
• mortality
• liver transplantation.