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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, José María Silva, J. T. Fernández Ruiz, Mario Cordero, Elisa Fortún, Jesús Gudiol González, Carlota Martínez Martínez, L. Vidal, Elisa Almenar, Luis Almirante, Benito Cantón, Rafael Carratalà, Jordi Caston, J. J. Cercenado, E. Cervera, Carlos Cisneros, José Miguel Crespo Leiro, María G. Cuervas Mons, Valentín Elizalde Fernández, J. Fariñas, María Carmen Gavaldà, Joan Goyanes, M. J. Gutiérrez Gutiérrez, B. Hernández, D. Len, Óscar López Andújar, Rafael López Medrano, Francisco Martín Dávila, Pilar Montejo, Miguel Moreno Camacho, Ma. Asunción Oliver, Antonio Pascual López, Antonio Pérez Nadales, E. Román Broto, A. San Juan, Rafael Serón Micas, Daniel Solé- over, A. Valerio, Maricela Muñoz, P. Torre Cisneros, Julián |
Keywords: | Malalties infeccioses Bacils Trasplantament d'òrgans Pseudomonas Communicable diseases Bacillus (Bacteria) Transplantation of organs Pseudomonas |
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: https://doi.org/10.1016/j.trre.2017.07.001 |
It is part of: | Transplantation Reviews, 2018, vol. 32, num. 1, p. 36-57 |
URI: | http://hdl.handle.net/2445/131300 |
Related resource: | https://doi.org/10.1016/j.trre.2017.07.001 |
ISSN: | 0955-470X |
Appears in Collections: | Articles publicats en revistes (Medicina) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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