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Review
. 2024 Dec 3;12(12):2493.
doi: 10.3390/microorganisms12122493.

Antibiotic Stewardship Based on Colonization with Multi-Drug-Resistant Bacteria in Liver Transplantation: A Narrative Review

Valentina Zuccaro  1   2 , Paola Giordani  2 , Francesca Binda  3 , Erika Asperges  2 , Elisa Farina  4 , Mauro Viganò  4 , Elena Gervasi  3 , Elisabetta Pagani  2 , Stefano Fagiuoli  4   5 , Raffaele Bruno  1   2
Affiliations
Review

Antibiotic Stewardship Based on Colonization with Multi-Drug-Resistant Bacteria in Liver Transplantation: A Narrative Review

Valentina Zuccaro et al. Microorganisms. .

Abstract

In solid organs post-transplant, bacterial infections can complicate the course of recovery with devastating consequences, such as graft loss and death. We provide an expert review on early post-liver transplant bacterial infections, with a focus on infections with multi-drug-resistant organism (MDRO) etiologies. Best practice recommendations are derived from a combination of available evidence and expert consensus. The main challenge in managing antibiotic therapy arises in patients with severe clinical conditions but negative MDRO screening results, as well as in those with positive MDRO screening results but uncomplicated infections. With the aim of shedding light on these "gray areas", we propose an algorithm where the patient is stratified as being at low risk or high risk of developing an MDRO infection.

Keywords: antibiotic stewardship; bacterial infections; colonization; liver transplantation; multi-drug-resistant organism.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Algorithm for management and treatment considerations in early liver transplant infections.
See this image and copyright information in PMC

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