Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Oct;24(5):e13874.
doi: 10.1111/tid.13874.

Brazilian perspective: antimicrobial stewardship in solid organ transplant

Ana Paula Matos Porto  1   2 , Bruno de Melo Tavares  2   3   4 , Denise Brandão de Assis  5 , Elisa Teixeira Mendes  6 , Evelyne Santana Girão  7 , Lauro Vieira Perdigão Neto  8 , Maria Alice Pimentel Falcão  9 , Maura Salaroli de Oliveira  3 , Maristela Pinheiro Freire  10 , Thais Guimaraes  10   11 , Tiago Arantes  9 , Anna Sara Levin  3   12 , Silvia Figueiredo Costa  2   12
Affiliations
Review

Brazilian perspective: antimicrobial stewardship in solid organ transplant

Ana Paula Matos Porto et al. Transpl Infect Dis. 2022 Oct.

Abstract

Background: The incidence of multidrug resistant organisms (MDROs) infections among solid organ transplant (SOT) patients is very high in Brazil.

Methods: This review will discuss antimicrobial use and resistance in SOT in Brazil, highlighting the main barriers and facilitators for implementation of an antimicrobial stewardship programme (ASP).

Results: The most common group of MDROs is carbapenem-resistant Gram-negative bacteria and vancomycin-resistant Enterococcus. Carbapenem-resistant Enterobacterales (CREs) are the most frequent MDROs and have been reported as donor-derived as well. Although ASPs are mandatory in the country, there is a lack of information regarding ASPs in SOT recipients. The main barriers for the implementation of ASPs in Brazilian hospitals are lack of electronic medical records, absence of national guidelines specific to SOT recipients, lack of recommendations on surveillance culture to evaluate colonization and transmission of donor-derived MDROs, limited availability of rapid diagnostic tests, and insufficient pharmacist and clinician time allocated to ASP activities in some SOT centers.

Conclusions: The incidence of MDRO infections caused mainly by VREs and CREs is very high in the country. There is limited data regarding antimicrobial use among SOT recipients in Brazil. The absence of antimicrobial stewardship national guidelines specific to SOT recipients is one of the main barriers for the implementation of ASPs in Brazilian hospitals.

Keywords: Brazil; antimicrobial resistance; antimicrobial stewardship; solid organ transplant.

PubMed Disclaimer

References

REFERENCES

    1. Lau TMM, Daniel R, Hughes K, et al. A systematic review investigating the use of microbiology outcome measures in randomized controlled trials evaluating antimicrobial stewardship interventions published between 2011 and 2021. JAC Antimicrob Resist. 2022;4(1):dlac013. https://doi.org/10.1093/jacamr/dlac013
    1. Dadgostar P. Antimicrobial resistance: implications and costs. Infect Drug Resist. 2019;12:3903-3910. https://doi.org/10.2147/IDR.S234610
    1. Murugaiyan J, Kumar PA, Rao GS, et al. Progress in alternative strategies to combat antimicrobial resistance: focus on antibiotics. Antibiotics (Basel). 2022;11(2):200. https://doi.org/10.3390/antibiotics11020200
    1. Nelson RE, Hyun D, Jezek A, Samore MH. Mortality, length of stay, and healthcare costs associated with multidrug-resistant bacterial infections among elderly hospitalized patients in the United States. Clin Infect Dis. 2021;74:ciab696. https://doi.org/10.1093/cid/ciab696
    1. ABTO. Registro Brasileiro de Transplante Ano XXVII No 2. 2021. Accessed 3 August 2022. Available at: http://www.abto.org.br/abtov03/Upload/file/RBT/2021/rbt-imprensa-leitura...

LinkOut - more resources