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Review
. 2024 Jun 17:37:12469.
doi: 10.3389/ti.2024.12469. eCollection 2024.

Burden and Management of Multi-Drug Resistant Organism Infections in Solid Organ Transplant Recipients Across the World: A Narrative Review

Maristela Pinheiro Freire  1 , Stephanie Pouch  2 , Abi Manesh  3 , Maddalena Giannella  4   5
Affiliations
Review

Burden and Management of Multi-Drug Resistant Organism Infections in Solid Organ Transplant Recipients Across the World: A Narrative Review

Maristela Pinheiro Freire et al. Transpl Int. .

Abstract

Solid organ transplant (SOT) recipients are particularly susceptible to infections caused by multidrug-resistant organisms (MDRO) and are often the first to be affected by an emerging resistant pathogen. Unfortunately, their prevalence and impact on morbidity and mortality according to the type of graft is not systematically reported from high-as well as from low and middle-income countries (HIC and LMIC). Thus, epidemiology on MDRO in SOT recipients could be subjected to reporting bias. In addition, screening practices and diagnostic resources may vary between countries, as well as the availability of new drugs. In this review, we aimed to depict the burden of main Gram-negative MDRO in SOT patients across HIC and LMIC and to provide an overview of current diagnostic and therapeutic resources.

Keywords: clinical impact; diagnosis and treatment; epidemiology; multidrug-resistant Gram-negative bacteria; new anti-infective agents; solid organ transplant.

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Conflict of interest statement

AM received scientific grants from the Wellcome Trust DBT alliance and the Indian Council of Medical Research. MG received a research grant from Pfizer, payment for lecture from Shionogi, MSD, Pfizer and BioMerieux. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Proportion of transplant activity in high-, lower- and upper middle-income countries.
FIGURE 2
FIGURE 2
Prevalence of Multidrug resistant Gram-negative bacterial infections in SOT recipients across the world.
FIGURE 3
FIGURE 3
Spectrum of various novel agents active against carbapenem-resistant Gram-negative organisms (modified from: European Respiratory Review 2022 31: 220119) *This drug may retain activity against serine-type carbapenemases (e.g., GES) but are inactivated by metallobetalactamases ^This combination has been shown to be active in vitro against some MBL producing P. aeruginosa strains.
FIGURE 4
FIGURE 4
Treatment flowchart.
See this image and copyright information in PMC

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