Highly resistant bacteria and donor‐derived infections: treading in uncharted territory

Sifri, Costi D.; Ison, Michael G.

doi:10.1111/j.1399-3062.2012.00752.x

Cited by 36 publications

(19 citation statements)

References 34 publications

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“…Moreover, due to miscommunication, patient 2B received only 3 days of full antibiotic treatment, and developed infection. Similar to other reports, our study highlights the importance of intra-and inter-institutional communication and cooperation (2,15,17).…”

Section: Casesupporting

confidence: 91%

“…CRE are the source of outbreaks and can be highly lethal, with a mortality rate of 40% in SOT recipients (14). There are few reports available on the optimal evaluation and management of these highly resistant bacteria in SOT donors and recipients (15)(16)(17)(18)(19)(20). In Italy, donors with bacteremia caused by carbapenemresistant gram-negative (CRGN) bacteria are routinely excluded for any organ donation.…”

Section: Introductionmentioning

confidence: 99%

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Outcome of Transplantation Using Organs From Donors Infected or Colonized With Carbapenem-Resistant Gram-Negative Bacteria

Mularoni

Bertani

Vizzini

et al. 2015

American Journal of Transplantation

111

116

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Donor-derived infections due to multidrug-resistant bacteria are a growing problem in solid organ transplantation, and optimal management options are not clear. In a 2-year period, 30/214 (14%) recipients received an organ from 18/170 (10.5%) deceased donors with infection or colonization caused by a carbapenemresistant gram-negative bacteria that was unknown at the time of transplantation. Among them, 14/30 recipients (47%) received a transplant from a donor with bacteremia or with infection/colonization of the transplanted organ and were considered at high risk of donor-derived infection transmission. The remaining 16/30 (53%) recipients received an organ from a nonbacteremic donor with colonization of a nontransplanted organ and were considered at low risk of infection transmission. Proven transmission occurred in 4 of the 14 high-risk recipients because donor infection was either not recognized, underestimated, or not communicated. These recipients received late, short or inappropriate posttransplant antibiotic therapy. Transmission did not occur in high-risk recipients who received appropriate and prompt antibiotic therapy for at least 7 days. The safe use of organs from donors with multidrug-resistant bacteria requires intra-and interinstitutional communication to allow appropriate management and prompt treatment of recipients in order to avoid transmission of infection.

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Section: Casesupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Outcome of Transplantation Using Organs From Donors Infected or Colonized With Carbapenem-Resistant Gram-Negative Bacteria

Mularoni

Bertani

Vizzini

et al. 2015

American Journal of Transplantation

111

116

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“…However, available guidelines do not describe risk-stratification related to transmission of bacterial infections from donors with endocarditis. Although successful use of organs from donors with subacute bacterial endocarditis without evidence of distant septic emboli has been reported (3,4), recent reports have described increased recipient morbidity and mortality associated with transmission of multidrug-resistant organisms (MDROs) (5–7). Potential donor-derived disease transmission events are reported to the Organ Procurement and Transplantation Network (OPTN) per policy and reviewed by the ad hoc OPTN Disease Transmission Advisory Committee (DTAC) which categorizes each as to the likelihood of disease transmission.…”

Section: Introductionmentioning

confidence: 99%

Transmission of Methicillin-Resistant Staphylococcus aureus Infection Through Solid Organ Transplantation: Confirmation Via Whole Genome Sequencing

Wendt

Kaul

Limbago

et al. 2014

American Journal of Transplantation

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We describe two cases of donor-derived methicillin-resistant Staphylococcus aureus (MRSA) bacteremia that developed after transplantation of organs from a common donor who died from acute MRSA endocarditis. Both recipients developed recurrent MRSA infection despite appropriate antibiotic therapy, and required prolonged hospitalization and hospital readmission. Comparison of S. aureus whole genome sequence of DNA extracted from fixed donor tissue and recipients’ isolates confirmed donor-derived transmission. Current guidelines emphasize the risk posed by donors with bacteremia from multidrug-resistant organisms. This investigation suggests that, particularly in the setting of donor endocarditis, even a standard course of prophylactic antibiotics may not be sufficient to prevent donor-derived infection.

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“…Some authors suggest that targeted antimicrobial treatment following transplantation can prevent transmission of MDR gram‐negative bacteria, although it has been reported that donor‐derived bacteremia can occur despite antibiotic prophylaxis . Other authors have proposed a course of at least 14 days of antibiotics in recipients of organs with positive donor cultures, whereas others conclude that it is not necessary to treat the recipient of an allograft from a donor with non‐bacteremic, localized infection that does not involve the transplanted organ, although prophylaxis should be adequate. It would seem prudent to recommend treatment or at least close monitoring of the recipient of an allograft from a donor with non‐bacteremic infection caused by MDR bacteria.…”

Section: Discussionmentioning

confidence: 99%

Successful liver transplantation despite donor‐transmitted ESBL‐producing Klebsiella pneumoniae infection: Case report and review of the literature

Escolà-Vergé

Los‐Arcos

González-López

et al. 2017

Transplant Infectious Dis

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Donor-derived bacterial infection is a recognized complication of solid organ transplantation. Patients admitted to the intensive care unit are increasingly exposed to infection with multidrug-resistant microorganisms. However, no specific recommendations are available about their suitability as donors. We report a case of donor-transmitted extended-spectrum beta-lactamase-producing Klebsiella pneumoniae infection in a liver recipient, and review the related literature.

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Highly resistant bacteria and donor‐derived infections: treading in uncharted territory

Cited by 36 publications

References 34 publications

Outcome of Transplantation Using Organs From Donors Infected or Colonized With Carbapenem-Resistant Gram-Negative Bacteria

Outcome of Transplantation Using Organs From Donors Infected or Colonized With Carbapenem-Resistant Gram-Negative Bacteria

Transmission of Methicillin-Resistant Staphylococcus aureus Infection Through Solid Organ Transplantation: Confirmation Via Whole Genome Sequencing

Successful liver transplantation despite donor‐transmitted ESBL‐producing Klebsiella pneumoniae infection: Case report and review of the literature

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