RT Journal Article
T1 Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations
A1 Aguado, J. M.
A1 Silva, J. T.
A1 Fernandez-Ruiz, M.
A1 Cordero, E.
A1 Fortun, J.
A1 Gudiol, C.
A1 Martinez-Martinez, L.
A1 Vidal, E.
A1 Almenar, L.
A1 Almirante, B.
A1 Canton, R.
A1 Carratala, J.
A1 Caston, J. J.
A1 Cercenado, E.
A1 Cervera, C.
A1 Cisneros, J. M.
A1 Crespo-Leiro, M. G.
A1 Cuervas-Mons, V.
A1 Elizalde-Fernandez, J.
A1 Farinas, M. C.
A1 Gavalda, J.
A1 Goyanes, M. J.
A1 Gutierrez-Gutierrez, B.
A1 Hernandez, D.
A1 Len, O.
A1 Lopez-Andujar, R.
A1 Lopez-Medrano, F.
A1 Martin-Davila, P.
A1 Montejo, M.
A1 Moreno, A.
A1 Oliver, A.
A1 Pascual, A.
A1 Perez-Nadales, E.
A1 Roman-Broto, A.
A1 San-Juan, R.
A1 Seron, D.
A1 Sole-Jover, A.
A1 Valerio, M.
A1 Munoz, P.
A1 Torre-Cisneros, J.
A1 Spanish Soc Transplantat SET, 
A1 Grp Study Infection Transplantat S, 
A1 Spanish Network Res Infe, 
K1 Lactamase-producing enterobacteriaceae
K1 Blood-stream infections
K1 Ventilator-associated pneumonia
K1 Extensively-drug-resistant
K1 Intensive-care-unit
K1 Urinary-tract-infections
K1 Acinetobacter-baumannii infections
K1 Pseudomonas-aeruginosa bacteremia
K1 High-risk patients
K1 Spectrum beta-lactamases
AB Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection. (C) 2017 Elsevier Inc. All rights reserved.
PB Elsevier science inc
SN 0955-470X
YR 2018
FD 2018-01-01
LK http://hdl.handle.net/10668/18889
UL http://hdl.handle.net/10668/18889
LA en
DS RISalud
RD Apr 11, 2025