scholarly journals Association between Nasal Carriage of Staphylococcus Aureus and Infection in Liver Transplant Recipients

2000 ◽  
Vol 31 (5) ◽  
pp. 1295-1299 ◽  
Author(s):  
F. Bert ◽  
J.-O. Galdbart ◽  
V. Zarrouk ◽  
J. Le Mee ◽  
F. Durand ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Liver Transplant ◽  
Nasal Carriage ◽  
Transplant Recipients ◽  
Liver Transplant Recipients

Staphylococcus AureusRectal Carriage and its Association with Infections in Patients in a Surgical Intensive Care Unit and a Liver Transplant Unit

2002 ◽  
Vol 23 (9) ◽  
pp. 495-501 ◽  
Author(s):  
Cheryl Squier ◽  
John D. Rihs ◽  
Kathleen J. Risa ◽  
Asia Sagnimeni ◽  
Marilyn M. Wagener ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Nasal Carriage ◽  
Pulsed Field Gel Electrophoresis ◽  
Surgical Intensive Care Unit ◽  
Transplant Recipients ◽  
Surgical Intensive Care ◽  
Liver Transplant Recipients

Background:The role of rectal carriage ofStaphylococcus aureusas a risk factor for nosocomialS. aureusinfections in critically ill patients has not been fully discerned.Methods:Nasal and rectal swabs forS. aureuswere obtained on admission and weekly thereafter until discharge or death from 204 consecutive patients admitted to the surgical intensive care unit and liver transplant unit.Results:Overall, 49.5% (101 of 204) of the patients never harboredS. aureus, 21.6% (44 of 204) were nasal carriers only, 3.4% (7 of 204) were rectal carriers only, and 25.5% (52 of 204) were both nasal and rectal carriers. Infections due toS. aureusdeveloped in 15.7% (32 of 204) of the patients; these included 3% (3 of 101) of the non-carriers, 18.2% (8 of 44) of the nasal carriers only, 0% (0 of 7) of the rectal carriers only, and 40.4% (21 of 52) of the patients who were both nasal and rectal carriers (P= .001). Patients with both rectal and nasal carriage were significantly more likely to developS. aureusinfection than were those with nasal carriage only (odds ratio, 3.9; 95% confidence interval, 1.18 to 7.85;P= .025). By pulsed-field gel electrophoresis, the infecting rectal and nasal isolates were clonally identical in 82% (14 of 17) of the patients withS. aureusinfections.Conclusions:Rectal carriage represents an underappreciated reservoir forS. aureusin patients in the intensive care unit and liver transplant recipients. Rectal plus nasal carriage may portend a greater risk forS. aureusinfections in these patients than currently realized.

STAPHYLOCOCCUS AUREUS NASAL COLONIZATION AND ASSOCIATION WITH INFECTIONS IN LIVER TRANSPLANT RECIPIENTS

1998 ◽  
Vol 65 (9) ◽  
pp. 1169-1172 ◽  
Author(s):  
Feng Yee Chang ◽  
Nina Singh ◽  
Timothy Gayowski ◽  
Stephanie D. Drenning ◽  
Marilyn M. Wagener ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Liver Transplant ◽  
Nasal Colonization ◽  
Transplant Recipients ◽  
Liver Transplant Recipients

Hepatic Iron Content and the Risk of Staphylococcus Aureus Bacteremia in Liver Transplant Recipients

2007 ◽  
Vol 17 (4) ◽  
pp. 332-336 ◽  
Author(s):  
Nina Singh ◽  
Cheryl Wannstedt ◽  
Lois Keyes ◽  
Debra Mayher ◽  
Lisa Tickerhoof ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Liver Transplant ◽  
Iron Content ◽  
Hepatic Iron ◽  
Transplant Recipients ◽  
Staphylococcus Aureus Bacteremia ◽  
Liver Transplant Recipients

Lack of efficacy of mupirocin in the prevention of infections with staphylococcus aureus in liver transplant recipients and candidates1

2003 ◽  
Vol 75 (2) ◽  
pp. 194-198 ◽  
Author(s):  
David L. Paterson ◽  
John D. Rihs ◽  
Cheryl Squier ◽  
Timothy Gayowski ◽  
Asia Sagnimeni ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Liver Transplant ◽  
Transplant Recipients ◽  
Prevention Of Infections ◽  
Liver Transplant Recipients

Impact of an Aggressive Infection Control Strategy on Endemic Staphylococcus aureus Infection in Liver Transplant Recipients

2006 ◽  
Vol 27 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Nina Singh ◽  
Cheryl Squier ◽  
Cheryl Wannstedt ◽  
Lois Keyes ◽  
Marilyn M. Wagener ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Confidence Interval ◽  
Infection Control ◽  
Liver Transplant ◽  
Active Surveillance ◽  
Odds Ratio ◽  
Intervention Program ◽  
Transplant Recipients ◽  
Surveillance Cultures ◽  
Liver Transplant Recipients

Background.Methicillin-resistant Staphylococcus aureus has emerged as a leading pathogen in transplant recipients and has become endemic in many institutions where transplantation is performed. The role of active surveillance programs based on the detection of colonization in the prevention of S. aureus infection in liver transplant recipients has not been defined.Methods.A total of 47 consecutive patients who underwent liver transplantation during 1996-1999 were compared with 97 patients who received a liver transplant during 2000-2004 after implementation of an intensive intervention program that included use of surveillance cultures to detect nasal and rectal colonization, use of cohorting and contact isolation precautions, and decolonization with intranasal mupirocin therapy.Results.The rate of new acquisition of S. aureus colonization of nares after transplantation decreased from 45.6% (21 of 46 patients) during the preintervention period to 9.9% (9 of 91 patients) during the postintervention period (P< .001). An increased length of hospital stay (odds ratio, 1.03; 95% confidence interval, 1.01-1.05; P < .002) was associated with new carriage acquisition, and transplantation during the postintervention period (odds ratio, 0.21; 95% confidence interval, 0.08-0.51; P<.001) was independently protective against new carriage. The rate of infection due to S. aureus decreased from 40.4% (19 of 47 patients) during the preintervention period to 4.1% (4 of 97 patients) during the postintervention period (P<.001), and the rate of bacteremia decreased from 25.5% (12 of 47 patients) to 4.1% (4 of 97 patients), respectively (P< .001). Overall, S. aureus infections occurred more frequently among patients with new carriage than among patients who were carriers at the time of transplantation (P< .001) or patients who were noncarriers (P< .001).Conclusions.Use of active surveillance cultures to detect colonization and implementation of targeted infection control interventions proved to be effective in curtailing new acquisition of S. aureus colonization and in decreasing the rate of S. aureus infection that was endemic in our population of liver transplant recipients.

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