Colonization with multidrug-resistant organisms is associated with in increased mortality in liver transplant candidates

Objectives: Rising prevalence of multidrug-resistant organisms (MDRO) is a major health problem in patients with liver cirrhosis. The impact of MDRO colonization in liver transplantation (LT) candidates and recipients on
Objectives: Rising prevalence of multidrug-resistant organisms (MDRO) is a major health problem in patients with liver cirrhosis. The impact of MDRO colonization in liver transplantation (LT) candidates and recipients on mortality has not been determined in detail.
Methods: Patients consecutively evaluated and listed for LT in a tertiary German liver transplant center from 2008 to 2018 underwent screening for MDRO colonization including methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant gram-negative bacteria (MDRGN), and vancomycin-resistant enterococci (VRE). MDRO colonization and infection status were obtained at LT evaluation, planned and unplanned hospitalization, three months upon graft allocation, or at last follow-up on the waiting list.
Results: In total, 351 patients were listed for LT, of whom 164 (47%) underwent LT after a median of 249 (range 0–1662) days. Incidence of MDRO colonization increased during waiting time for LT, and MRDO colonization was associated with increased mortality on the waiting list (HR = 2.57, p<0.0001. One patients was colonized with a carbapenem-resistant strain at listing, 9 patients acquired carbapenem-resistant gram-negative bacteria (CRGN) on the waiting list, and 4 more after LT. In total, 10 of these 14 patients died.
Conclusions: Colonization with MDRO is associated with increased mortality on the waiting list, but not in short-term follow-up after LT. Moreover, colonization with CRGN seems associated with high mortality in liver transplant candidates and recipients.
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Metadaten
Author:Philip Ferstl, Natalie Filmann, Eva-Maria Heilgenthal, Andreas Schnitzbauer, Wolf Otto Bechstein, Volkhard A. J. Kempf, David Villinger, Tilman Schultze, Michael Hogardt, Christoph Stephan, Haitham Mutlak, Nina Weiler, Marcus Maximilian Mücke, Jonel Trebicka, Stefan Zeuzem, Oliver Waidmann, Martin-Walter Welker
URN:urn:nbn:de:hebis:30:3-612465
DOI:http://dx.doi.org/10.1371/journal.pone.0245091
ISSN:1932-6203
Parent Title (English):PLOS ONE
Publisher:Public Library of Science
Place of publication:San Francisco
Document Type:Article
Language:English
Date of Publication (online):2021/01/22
Date of first Publication:2021/01/22
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2021/06/28
Tag:Methicillin-resistant Staphylococcus aureus; cirrhosis; death rates; enterobacter infections; pseudomonas aeruginosa; epidemiology; epidemiology; liver transplantation; medical risk factors; pseudomonas aeruginosa
Volume:16
Issue:1, art. e0245091
Pagenumber:13
First Page:1
Last Page:13
HeBIS PPN:483291358
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Open-Access-Publikationsfonds:Medizin
Licence (German):License LogoCreative Commons - Namensnennung 4.0

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