TY  - JOUR
A1  - Ferstl, Philip
A1  - Filmann, Natalie
A1  - Heilgenthal, Eva-Maria
A1  - Schnitzbauer, Andreas
A1  - Bechstein, Wolf Otto
A1  - Kempf, Volkhard A. J.
A1  - Villinger, David
A1  - Schultze, Tilman
A1  - Hogardt, Michael
A1  - Stephan, Christoph
A1  - Mutlak, Haitham
A1  - Weiler, Nina
A1  - Mücke, Marcus Maximilian
A1  - Trebicka, Jonel
A1  - Zeuzem, Stefan
A1  - Waidmann, Oliver
A1  - Welker, Martin-Walter
T1  - Colonization with multidrug-resistant organisms is associated with in increased mortality in liver transplant candidates
T2  - PLOS ONE
N2  - 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.
KW  - Methicillin-resistant Staphylococcus aureus
KW  - medical risk factors
KW  - liver transplantation
KW  - death rates
KW  - cirrhosis
KW  - enterobacter infections; pseudomonas aeruginosa; epidemiology
KW  - pseudomonas aeruginosa
KW  - epidemiology
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/61246
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-612465
SN  - 1932-6203
VL  - 16
IS  - 1, art. e0245091
SP  - 1
EP  - 13
PB  - Public Library of Science
CY  - San Francisco
ER  -