Antibiotic Utilization in Deceased Organ Donors

Anesi, Judith A; Lautenbach, Ebbing; Han, Jennifer; Lee, Dong Heun; Clauss, Heather; Climaco, Antonette; Bilker, Warren B.; Molnar, Esther; Alimenti, Darcy; West, Sharon; Tolomeo, Pam; Blumberg, Emily A.

doi:10.1093/cid/ciab463

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…Deceased donors frequently receive broad-spectrum antibiotics, some of which may provide redundant coverage [35] and could thereby increase the risk of MDRO colonization. Further, antibiotic utilization varies across OPOs [36], and differences in antibiotic use may relate to local experience, regional epidemiology in the context of broader geographic organ sharing, perceived risk of donor MDRO colonization, and requests made by accepting centers.…”

Section: Future Directionsmentioning

confidence: 99%

Deceased donors with multidrug-resistant organisms: implications and future directions

Pouch

Ison

2022

Current Opinion in Organ Transplantation

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Purpose of reviewOrgan utilization from donors infected or colonized with multidrug-resistant organisms (MDROs) remains inconsistent, and hesitancy to accept organs from these donors may relate to poor outcomes among solid organ transplant recipients with MDRO donor-derived infections (DDIs). An improved understanding of the risk factors for donor MDRO colonization or infection and the risk of MDRO DDI is needed to safely expand the donor pool while minimizing unnecessary organ discard.Recent findingsRecent studies have begun to delineate risk factors for MDRO acquisition among deceased donors and the epidemiology of MDRO DDIs, but additional efforts are warranted to inform optimal approaches to donor evaluation, risk stratification, management, interfacility and interagency data sharing, and approaches to recipient management.SummaryThis review summaries recent data regarding risk factors for MDRO colonization and infection in deceased donors, epidemiology of MDRO DDIs, and current approaches to donors harboring MDROs and provides a framework for future research and collaboration.

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Section: Future Directionsmentioning

confidence: 99%

Deceased donors with multidrug-resistant organisms: implications and future directions

Pouch

Ison

2022

Current Opinion in Organ Transplantation

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Challenges of Antimicrobial Resistance and Stewardship in Solid Organ Transplant Patients

Walti

2022

Curr Infect Dis Rep

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Purpose of Review Without effective antimicrobials, patients cannot undergo transplant surgery safely or sustain immunosuppressive therapy. This review examines the burden of antimicrobial resistance in solid organ transplant recipients and identifies opportunities for antimicrobial stewardship. Recent Findings Antimicrobial resistance has been identified to be the leading cause of death globally. Multidrug-resistant pathogens are associated with significant morbidity and mortality in transplant recipients. Methicillin-resistant S. aureus affects liver and lung recipients, causing bacteremia, pneumonia, and surgical site infections. Vancomycin-resistant enterococci is a nosocomial pathogen primarily causing bacteremia in liver recipients. Multidrug-resistant Gram-negative pathogens present urgent and serious threats to transplant recipients. Extended-spectrum beta-lactamase-producing E. coli and K. pneumoniae commonly cause bacteremia and intra-abdominal infections in liver and kidney recipients. Carbapenemase-producing Enterobacterales, mainly K. pneumoniae , are responsible for infections early-post transplant in liver, lung, kidney, and heart recipients. P. aeruginosa and A. baumannii continue to be critical threats. While there are new antimicrobial agents targeting resistant pathogens, judicious prescribing is crucial to minimize emerging resistance. The full implications of the COVID-19 global pandemic on antimicrobial resistance in transplant recipients remain to be understood. Currently, there are no established standards on the implementation of antimicrobial stewardship interventions, but strategies that leverage existing antimicrobial stewardship program structure while tailoring to the needs of transplant recipients may help to optimize antimicrobial use. Summary Clinicians caring for transplant recipients face unique challenges tackling emerging antimcirobial resistance. Coordinated antimicrobial stewardship interventions in collaboration with appropriate expertise in transplant and infectious diseases may mitigate against such threats.

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Minimizing the Risk of Donor-Derived Events and Maximizing Organ Utilization Through Education and Policy Development

Hoz

2023

Infectious Disease Clinics of North America

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Antibiotic Utilization in Deceased Organ Donors

Cited by 4 publications

References 10 publications

Deceased donors with multidrug-resistant organisms: implications and future directions

Deceased donors with multidrug-resistant organisms: implications and future directions

Challenges of Antimicrobial Resistance and Stewardship in Solid Organ Transplant Patients

Minimizing the Risk of Donor-Derived Events and Maximizing Organ Utilization Through Education and Policy Development

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