BACKGROUND: Vancomycin-resistant enterococcal (VRE) infections cause significant morbidity and mortality amongst SOT recipients. However, little is known about the relevance of VRE in small intestinal transplant recipients.

METHODS: We performed a retrospective chart review on eligible patients between April 2005 and July 2011, using patient data retrieved from computerized patient databases. Statistical analysis was performed using Chi square, Fisher's exact test and logistic regression analysis.

RESULTS: 86 patients were enrolled in our study, and 48.8% (42 of 86) had VRE colonization or infection (C/I). Sites of VRE C/I included: 17 wound (28.3%), 16 stool (26.6%), 13 intra-abdominal (21.7%), 7 urine (11.7%) and 7 blood (11.7%). The average length of stay post transplantation was 122 days (Range 33-319) in patients who had VRE C/I vs. 78 days (Range 0 to 215) for patients in whom no VRE was identified (p=0.0019). During the observation period, the overall patient mortality was 18.6% (16/86 patients); 21.4% (9/42) of patients in the VRE group died vs. 15.9% (7/44) in the group where VRE was not identified (p = 0.51,n.s.). Patients with VRE C/I had an average of 6 re-admissions vs. patients without VRE C/I had an average of 4 re-admissions (p=0.0160). The average total number of infections caused by any organism and at any site was 5 in transplant recipients with VRE C/I versus 3 in the patients who did not have VRE C/I (p=0.0021).

CONCLUSION: Small intestinal transplant recipients with VRE C/I experience greater morbidity but not greater mortality compared with those without VRE C/I. VRE C/I may be a surrogate of increased morbidity in this patient population and our findings are consistent with what has been previously reported in VRE colonized liver transplant recipients.

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