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Title: Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations
Author: Aguado, J. M.
Silva, J. T.
Fernández Ruiz, M.
Cordero, E.
Fortún, J.
Gudiol, C.
Martínez Martínez, L.
Vidal, E.
Almenar, L.
Almirante, B.
Cantón, R.
Carratalà, Jordi
Caston, J. J.
Cercenado, E.
Cervera, Carlos
Cisneros, J. M.
Crespo Leiro, M. G.
Cuervas Mons, V.
Elizalde Fernández, J.
Fariñas, M. C.
Gavaldà, J.
Goyanes, M. J.
Gutiérrez Gutiérrez, B.
Hernández, D.
Len, O.
López Andujar, R.
López Medrano, F.
Martín Dávila, P.
Montejo, M.
Moreno Camacho, Ma. Asunción
Oliver, A.
Pascual, A.
Pérez Nadales, E.
Román Broto, A.
San Juan, R.
Serón, D.
Solé-Jover, A.
Valerio, Maricela
Muñoz, P.
Torre Cisneros, J.
Keywords: Malalties infeccioses
Trasplantament d'òrgans
Communicable diseases
Bacillus (Bacteria)
Transplantation of organs
Issue Date: Jan-2018
Publisher: Elsevier
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.
Note: Versió postprint del document publicat a:
It is part of: Transplantation Reviews, 2018, vol. 32, num. 1, p. 36-57
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ISSN: 0955-470X
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Ciències Clíniques)

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