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Title: Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations.
Authors: 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
Carratalá, J
Caston, J J
Cercenado, E
Cervera, C
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, A
Oliver, A
Pascual, A
Pérez-Nadales, E
Román-Broto, A
San-Juan, R
Serón, D
Solé-Jover, A
Valerio, M
Muñoz, P
Torre-Cisneros, J
Spanish Society of Transplantation (SET)
Group for Study of Infection in Transplantation of the Spanish Society of Infectious Diseases and Clinical Microbiology (GESITRA-SEIMC)
Spanish Network for Research in Infectious Diseases (REIPI) (RD16/0016)
metadata.dc.subject.mesh: Anti-Bacterial Agents
Disease Management
Drug Resistance, Multiple
Gram-Negative Bacterial Infections
Organ Transplantation
Postoperative Complications
Tissue Donors
Transplant Recipients
Issue Date: 26-Jul-2017
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.
metadata.dc.identifier.doi: 10.1016/j.trre.2017.07.001
Appears in Collections:Producción 2020

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