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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, José Miguel; 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.
Other authors:	Universitat de Barcelona
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.
Subject(s):	-Malalties infeccioses -Bacils -Trasplantament d'òrgans -Pseudomonas -Communicable diseases -Bacillus (Bacteria) -Transplantation of organs -Pseudomonas
Rights:	cc-by-nc-nd (c) Elsevier, 2018 http://creativecommons.org/licenses/by-nc-nd/3.0/es
Document type:	Article Article - Accepted version
Published by:	Elsevier
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