Association between gut colonization of vancomycin-resistant enterococci and liver transplant outcomes

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dc.contributor.authorChiang, Diana
dc.contributor.authorDingle, Tanis C.
dc.contributor.authorBelga, Sara
dc.contributor.authorKabbani, Dima
dc.contributor.authorBhanji, Rahima A.
dc.contributor.authorWalter, Jens
dc.contributor.authorAbraldes, Juan G.
dc.contributor.authorCervera, Carlos
dc.date.accessioned2022-03-11T11:22:56Z
dc.date.available2022-03-11T11:22:56Z
dc.date.issued2022-03-05
dc.date.updated2022-03-10T15:22:39Z
dc.description.abstractBackground: Vancomycin-resistant enterococci (VRE) colonization is common in liver transplant recipients and has been associated with worse post-transplant outcomes. Methods: We conducted a retrospective cohort study at the University of Alberta Hospital including patients who underwent a liver transplant between September 2014 and December 2017. Results: Of 343 patients, 68 (19.8%) had pre-transplant VRE colonization and 27 (27/275, 9.8%) acquired VRE post-transplant, 67% were males and the median age was 56.5 years. VRE colonized patients at baseline had higher MELD scores and required longer post-transplant hospitalization. VRE colonization was associated with increased risk of early acute kidney injury (AKI) (64% vs 52%, p = 0. 044), clinically significant bacterial/fungal infection (29% vs 17%, p = 0. 012) and invasive VRE infection (5% vs 1%, p = 0. 017). Mortality at 2-years was 13% in VRE-colonized versus 7% in non-colonized (p = 0.085). On multivariate analysis, VRE colonization increased the risk of post-transplant AKI (HR 1.504, 95% CI: 1.077-2.100, p = 0.017) and clinically significant bacterial or fungal infection at 6 months (HR 2.038, 95%CI: 1.222-3.399, p = 0.006), and was associated with non-significant trend towards increased risk of mortality at 2-years post-transplant (HR 1.974 95% CI 0.890-4.378; p = 0.094). Conclusions: VRE colonization in liver transplant patients is associated with increased risk of early AKI, clinically significant infections, and a trend towards increased mortality at 2-years.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationChiang, D., Dingle, T. C., Belga, S., Kabbani, D., Bhanji, R. A., Walter, J., Abraldes, J. G. and Cervera, C. (2022) 'Association between gut colonization of vancomycin-resistant enterococci and liver transplant outcomes', Transplant Infectious Disease. doi: 10.1111/tid.13821en
dc.identifier.doi10.1111/tid.13821en
dc.identifier.eissn1399-3062
dc.identifier.issn1398-2273
dc.identifier.journaltitleTransplant Infectious Diseaseen
dc.identifier.urihttps://hdl.handle.net/10468/12892
dc.language.isoenen
dc.publisherJohn Wiley & Sons, Inc.en
dc.rights© 2022, John Wiley & Sons Ltd. This is the accepted version of the following item: Chiang, D., Dingle, T. C., Belga, S., Kabbani, D., Bhanji, R. A., Walter, J., Abraldes, J. G. and Cervera, C. (2022) 'Association between gut colonization of vancomycin-resistant enterococci and liver transplant outcomes', Transplant Infectious Disease, doi: 10.1111/tid.13821, which has been published in final form at: https://doi.org/10.1111/tid.13821. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.en
dc.subjectVancomycin-resistant enterococcien
dc.subjectLiver transplantationen
dc.subjectPost-transplant outcomesen
dc.subjectMicrobiotaen
dc.subjectVRE colonizationen
dc.subjectAcute kidney injuryen
dc.subjectMELDen
dc.subjectMortalityen
dc.titleAssociation between gut colonization of vancomycin-resistant enterococci and liver transplant outcomesen
dc.typeArticle (peer-reviewed)en
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