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

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

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Aguado, JM
  • Silva, JT
  • Fernandez-Ruiz, M
  • Cordero, E
  • Fortun, J
  • Gudiol, C
  • Martinez-Martinez, L
  • Vidal, E
  • Almirante, B
  • Canton, R
  • Carratala, J
  • Caston, JJ
  • Cercenado, E
  • Cervera, C
  • Cisneros, JM
  • Crespo-Leiro, MG
  • Cuervas-Mons, V
  • Elizalde-Fernandez, J
  • Fariñas MC
  • Gavalda, J
  • Goyanes, MJ
  • Gutierrez-Gutierrez, B
  • Hernandez, D
  • Len, O
  • Lopez-Medrano, F
  • Martin-Davila, P
  • Montejo, M
  • Moreno, A
  • Oliver, A
  • Pascual, A
  • Perez-Nadales, E
  • Roman-Broto, A
  • San-Juan, R
  • Seron, D
  • Valerio, M
  • Muñoz P
  • Torre-Cisneros, J
  • Spanish Soc Transplantat SET
  • Group for Study of Infection in Transplantation of the Spanish Society of Infect
  • Spanish Network for Research in Infectious Diseases (REIPI) (RD16/0016)

Grupos

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. (C) 2017 Elsevier Inc. All rights reserved.

Datos de la publicación

ISSN/ISSNe:
0955-470X, 1557-9816

TRANSPLANTATION REVIEWS  ELSEVIER SCIENCE INC

Tipo:
Article
Páginas:
36-57
PubMed:
28811074
Factor de Impacto:
0,894 SCImago ℠
Cuartil:
Q2 SCImago ℠

Citas Recibidas en Web of Science: 127

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Keywords

  • LACTAMASE-PRODUCING ENTEROBACTERIACEAE; BLOOD-STREAM INFECTIONS; VENTILATOR-ASSOCIATED PNEUMONIA; EXTENSIVELY-DRUG-RESISTANT; INTENSIVE-CARE-UNIT; URINARY-TRACT-INFECTIONS; ACINETOBACTER-BAUMANNII INFECTIONS; PSEUDOMONAS-AERUGINOSA BACTEREMIA; HIGH-RISK PATIENTS; SPECTRUM BETA-LACTAMASES

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