Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations.

Content Provider	Semantic Scholar
Author	Aguado, José María Silva, José Tiago Fernández-Ruiz, Mario Cordero, Elisa Fortun, Jesús Gudiol, C. Martinez-Martinez, Luis Vidal, Elisa Mosler Almenar, L. Puertes Almirante, Benito Cantón, Rafael Carratalà, Jordi Castón, Juan José Cercenado, Emilia Cervera, Carlos Cisneros, José Miguel Calvillo Crespo-Leiro, María Generosa Cuervas-Mons, Valentin Elizalde-Fernández, J. Fariñas, Mª Carmen Gavaldà, Joan Goyanes, María José Gutiérrez-Gutiérrez, Belén Hernández, Domingo Len, Oscar López-Andújar, R. López-Medrano, Francisco Martín-Dávila, Pilar Montejo, Miguel Francisco Canessa Moreno, Asunción Oliver, Antonio Pascual, Alvaro Pascual-Leone Pérez-Nadales, Elena Román-Broto, Antonio San-Juan, R. Serón, Daniel Solé-Jover, A. Valerio, Maricela Muñoz, Patricia Cisneros, Julián Torre‐
Copyright Year	2018
Abstract	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.
Starting Page	36
Ending Page	57
Page Count	22
File Format	PDF HTM / HTML
DOI	10.1016/j.trre.2017.07.001
Alternate Webpage(s)	http://diposit.ub.edu/dspace/bitstream/2445/131300/1/676788.pdf
PubMed reference number	28811074
Alternate Webpage(s)	https://doi.org/10.1016/j.trre.2017.07.001
Journal	Medline
Volume Number	32
Issue Number	1
Journal	Transplantation reviews
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article