EFFECT OF ANTIBIOTIC-PROPHYLAXIS WITH VAN COMYCIN OVER METHICILLIN-RESISTANT - STAPHYLOCOCCUS-AUREUS INFECTION AFTER LIVER-TRANSPLANTATION

An epidemic outbreak of Methicillin-resistant Staphylococcus Aureus (M RSA) infections affecting liver transplantation patients was detected in our hospital. In this study we describe the special characteristics of the infections and the results of profilactic treatment with Vanco mycin. Between april 1990 and december 1991, 47 patients with mean age of 54,4+/-10 years underwent liver transplantation. The patients were included in two cronological groups: 1) Group I: 20 patients not trea ted prophylactically with Vancomycin; 2) Group II: 27 consecutive pati ents treated with Vancomycin. Sistematical cultures of body fluids for bacteria and fungi were done in every patient, and were repeated afte r 24 hours. The cultures were repeated again in case of sepsis. Group I patients had a significantly higher frecuence of MRSA infections tha n group II patients. Furthermore, in patients with MRSA infection, ind ependently of the group, duration of transplantation (p < 0.01), reope rations (p < 0.001) and prophylactic treatment with Vancomycin (p < 0. 001) were significative factors. In conclusion, Vancomycin appears to be an elective prophylactic antibiotic in case of high risk of MRSA se psis after liver transplantation.