Colonisation with methicillin-resistantStaphylococcus aureusprior to renal transplantation is associated with long-term renal allograft failure

Abstract

Renal transplant recipients are at an increased risk of developing Methicillin-resistant Staphylococcus aureus due to their immunosuppressed status. Herein, we investigate the incidence of MRSA infection in patients undergoing renal transplantation and determine the effect of MRSA colonisation on renal allograft function and overall mortality. Between January 1st 2007 and December 31st 2012, 1499 consecutive kidney transplants performed in our transplant unit and a retrospective 1:2 matched case-control study was performed on this patient cohort. The 1-, 3- and 5-year overall graft survival rates were 100%, 86% and 78%, respectively, in MRSA positive recipients compared with 100%, 100% and 93%, respectively, in the control group (P<0.05). The 1-, 3- and 5-year overall patient survival rates were 100%, 97% and 79%, respectively, in MRSA positive recipients compared with 100%, 100% and 95%, respectively, in the control group (P=0.1). In a multiple logistic regression analysis, colonisation with MRSA pre-operatively was an independent predictor for renal allograft failure at 5 years (hazard ratio: 4.6, 95% confidence interval: 1-30.7, P=0.048). These findings demonstrate that the incidence of long-term renal allograft failure is significantly greater in this patient cohort compared with a matched control population.