Premium
Epidemiology and outcomes of pretransplant methicillin‐resistant Staphylococcus Aureus screening in pediatric solid organ transplant candidates
Author(s) -
Paulsen Grant,
Blum Samantha,
DanzigerIsakov Lara
Publication year - 2018
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13246
Subject(s) - medicine , epidemiology , incidence (geometry) , methicillin resistant staphylococcus aureus , retrospective cohort study , transplantation , organ transplantation , cohort , staphylococcus aureus , surgery , pediatrics , physics , biology , bacteria , optics , genetics
MRSA infection following SOT is an important cause of morbidity and mortality, but epidemiology and risk factors for colonization prior to pediatric SOT remain unclear. A retrospective cohort of SOT patients ≤21 years of age from 2009 to 2014 was evaluated. Demographics, MRSA screens, timing of transplantation, and MRSA infection were abstracted. From 2013 to 2014, 130 SOT candidates were screened or had known prior MRSA infection. Seventeen patients (13%) were MRSA colonized. Liver transplant candidates were least likely to be colonized ( OR 0.22, CI :0.06‐0.81, P = .02); greatest risk of colonization was in lung ( OR 18.7, CI :1.9‐182.3, P = .03), abdominal multivisceral ( OR 7.5, CI :1.5‐38.6, P = .02), and cardiac patients with history of cardiothoracic surgery ( OR 8.0, CI :1.7‐36.0, P = .007). In univariable analysis, African American patients were more likely to be colonized ( OR 7.1, CI :2.49‐19.41, P = .0005). There were 3 early MRSA infections in screened patients, incidence of 3.9%; only one in a colonized patient. Thirteen percent of screened pediatric SOT candidates were MRSA colonized, with greatest risk in lung, multivisceral and cardiac patients with prior cardiothoracic surgery. Early MRSA infection occurred in 3.9% of transplanted patients. Cardiothoracic and multivisceral organ transplant candidates may benefit the most from targeted MRSA screening.