Consequences of vancomycin-resistant Enterococcus in liver transplant recipients: a matched control study

: Background: Liver transplant recipients are at high risk for multi‐drug resistant infections because of broad‐spectrum antibiotic and immunosuppression. This study evaluates the clinical and financial impact of vancomycin resistant Enterococcus (VRE) in liver transplant recipients. Methods: Liver transplant recipients with VRE from 1995 to 2002 were identified and matched (age, gender, UNOS status, liver disease and transplant date) to controls. Demographics, clinical factors, co‐infections, antibiotic use, length of stay, abdominal surgeries, biliary complications, survival and resource utilization were compared with matched controls. Results: Nineteen patients were found to have 28 VRE infections via evaluation of microbiologic culture results of all liver transplant patients in the transplant registry. Thirty‐eight non‐VRE patients served as matched controls. The four most common sites VRE was cultured from included blood (35%), peritoneal fluid (35%), bile (20%), and urine (12%). Median time from transplant to infection was 48 d (range of 4–348). No significant differences in demographics were observed. The VRE group had a higher incidence of prior antibiotic use than the non‐VRE group (95% vs. 34%; p