Candida auris outbreak involving liver transplant recipients in a surgical intensive care unit

2020 ◽  
Vol 20 (12) ◽  
pp. 3673-3679 ◽  
Author(s):  
Nicole M. Theodoropoulos ◽  
Barbara Bolstorff ◽  
Adel Bozorgzadeh ◽  
Christina Brandeburg ◽  
Melissa Cumming ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Surgical Intensive Care Unit ◽  
Transplant Recipients ◽  
Candida Auris ◽  
Surgical Intensive Care ◽  
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.

Practical methods for effective vancomycin-resistant enterococci (VRE) surveillance: experience in a liver transplant surgical intensive care unit

2018 ◽  
Vol 39 (10) ◽  
pp. 1178-1182 ◽  
Author(s):  
Rebecca Y. Linfield ◽  
Shelley Campeau ◽  
Patil Injean ◽  
Aric Gregson ◽  
Fady Kaldas ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Tertiary Care ◽  
Point Prevalence ◽  
Surgical Intensive Care Unit ◽  
Fisher Exact Test ◽  
Surgical Intensive Care ◽  
Stool Samples ◽  
Vancomycin Resistant

AbstractObjectiveWe evaluated the utility of vancomycin-resistant Enterococcus (VRE) surveillance by varying 2 parameters: admission versus weekly surveillance and perirectal swabbing versus stool sampling.DesignProspective, patient-level surveillance program of incident VRE colonization.SettingLiver transplant surgical intensive care unit (SICU) of a tertiary-care referral medical center with a high prevalence of VRE.PatientsAll patients admitted to the SICU from June to August 2015.MethodsWe conducted a point-prevalence estimate followed by admission and weekly surveillance by perirectal swabbing and/or stool sampling. Incident colonization was defined as a negative screen followed by positive surveillance. VRE was detected by culture on Remel Spectra VRE chromogenic agar. Microbiologically-confirmed VRE bloodstream infections (BSIs) were tracked for 2 months. Statistical analyses were calculated using the McNemar test, the Fisher exact test, the t test, and the χ2 test.ResultsIn total, 91 patients underwent VRE surveillance testing. The point prevalence of VRE colonization was 60.9%; VRE prevalence on admission was 30.1%. Weekly surveillance identified an additional 7 of 28 patients (25.0%) with incident colonization. VRE BSIs were more common in VRE-colonized patients than in noncolonized patients (8 of 43 vs 2 of 48; P=.028). In a direct comparison, perirectal swabs were more sensitive than stool samples in detecting VRE (64 of 67 vs 56 of 67; P=.023). Compliance with perirectal swabbing was 89% (201 of 226) compared to 56% (127 of 226) for stool collection (P≤0.001).ConclusionsWe recommend weekly VRE surveillance over admission-only screening in high-burden units such as liver transplant SICUs. Perirectal swabs had greater collection compliance and sensitivity than stool samples, making them the preferred methodology. Further work may have implications for antimicrobial stewardship and infection control.

scholarly journals Procalcitonin as a prognostic marker for infectious complications in liver transplant recipients in an intensive care unit

2010 ◽  
Vol 16 (3) ◽  
pp. 402-410 ◽  
Author(s):  
Maartje A. J. van den Broek ◽  
Steven W. M. Olde Damink ◽  
Bjorn Winkens ◽  
Christoph E. Broelsch ◽  
Massimo Malagó ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Prognostic Marker ◽  
Infectious Complications ◽  
Transplant Recipients ◽  
Liver Transplant Recipients

PULMONARY INFILTRATES IN LIVER TRANSPLANT RECIPIENTS IN THE INTENSIVE CARE UNIT

1999 ◽  
Vol 67 (8) ◽  
pp. 1138-1144 ◽  
Author(s):  
Nina Singh ◽  
Timothy Gayowski ◽  
Marilyn M. Wagener ◽  
Ignazio R. Marino
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Transplant Recipients ◽  
Pulmonary Infiltrates ◽  
Liver Transplant Recipients

Fever in liver transplant recipients in the intensive care unit 1

1999 ◽  
Vol 13 (6) ◽  
pp. 504-511 ◽  
Author(s):  
Nina Singh ◽  
Feng Yee Chang ◽  
Timothy Gayowski ◽  
Marilyn Wagener ◽  
Ignazio R Marino
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Transplant Recipients ◽  
Liver Transplant Recipients
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