Clinical Significance of Vancomycin Resistant Enterococcus in Liver Transplantation.
- Author:
Eun Kyung CHOE
1
;
Kyung Suk SUH
;
Jai Young CHO
;
Hae Won LEE
;
Eung Ho CHO
;
Nam Joon YI
;
Kuhn Uk LEE
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. kssuh@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Liver transplantation;
Vancomycin;
Vancomycin resistant enterococcus;
Infection;
Colonization
- MeSH:
Ascites;
Bile;
Catheters;
Cause of Death;
Cholestasis;
Colon;
Drainage;
Endocarditis;
Enterococcus*;
Gastrointestinal Tract;
Gastroscopy;
Hematoma;
Hemorrhage;
Humans;
Incidence;
Length of Stay;
Liver Transplantation*;
Liver*;
Methicillin-Resistant Staphylococcus aureus;
Mortality;
Pneumonia;
Sepsis;
Transplants;
Vancomycin*
- From:The Journal of the Korean Society for Transplantation
2006;20(2):241-247
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose: Recently the incidence of vancomycin resistant enterococcus (VRE) infection and colonization has increased in the hospitalized patients. The purpose of present study is to examine the clinical significance of VRE infection and colonization in liver transplantation (LT) patients and to investigate the outcome. Methods: Among 194 patients who underwent LT from January 2001 to July 2004, 15 patients had at least one report of culture positive of VRE (VRE(+)). We compared the clinical outcome of 15 VRE(+) patients with those of VRE(-) patients. Results: One year mortality was higher in VRE(+) patients than VRE(-) patients (27% vs 4%; P=0.0001). Causes of death were primary graft non-function, infective endocarditis, MRSA sepsis and CMV pneumonitis. Mean duration of hospital stay was 102+/-63 days in VRE(+) patients, which shows significant difference with 51+/-30 days in VRE(-) patients (P=0.008). Cases who underwent gastroscopy (1.00+/-1.51 vs. 0.12+/-0.47; P=0.04) and percutaneous catheter drainage (1.33+/-1.49 vs. 0.40+/-1.05; P=0.03) were significantly more frequent in VRE(+) patients. The findings of gastroscopy were upper gastrointestinal bleeding (n=4), and bile duct obstruction (n=1). The contents of percutaneous catheter drainage were hematoma (n=3), bile juice (n=3) and ascites (n=1). Conclusion: VRE infected patients experienced more frequently gastrointestinal tract complications including bleeding or biliary complication and they showed higher 1-year mortality rate, although these patients died of causes other than VRE infection.
