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Review
. 2025 Jul;39(3):100937.
doi: 10.1016/j.trre.2025.100937. Epub 2025 May 21.

Management of multidrug-resistant gram-negative bacilli infections in adult solid organ transplant recipients: GESITRA-IC/SEIMC, CIBERINFEC, and SET recommendations update

Affiliations
Review

Management of multidrug-resistant gram-negative bacilli infections in adult solid organ transplant recipients: GESITRA-IC/SEIMC, CIBERINFEC, and SET recommendations update

Isabel Rodríguez-Goncer et al. Transplant Rev (Orlando). 2025 Jul.

Abstract

Multidrug-resistant (MDR) Gram-negative bacilli (GNB) infections in solid organ transplant (SOT) recipients continue to pose a significant threat despite advances in diagnostics and treatments. The last international consensus guidelines of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) on the management of MDR GNB in adult solid organ transplant (SOT) recipients were published in 2018, underscoring the need for an update to incorporate recent advances, particularly the availability of new drugs that may improve the current standard of care. A working group consisting of members from the Study Group of Infection in Transplantation and Immunocompromised Hosts (GESITRA-IC) of SEIMC, the Center for Biomedical Research Network in Infectious Diseases (CIBERINFEC) and the Spanish Society of Transplantation (SET) developed consensus-based recommendations for managing MDR GNB infections during the transplant procedure. Recommendations were categorized based on evidence quality and strength, utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The final recommendations were endorsed through a consensus meeting and approved by the expert panel.

Keywords: Gram-negative bacilli; Management; Multidrug resistance; Prevention; Solid organ transplantation.

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Conflict of interest statement

Declaration of competing interest Rodríguez-Goncer I has received honoraria for educational activities and travel support for scientific purposes from Pfizer and Gilead. Ruiz-Arabi E has received honoraria for speaking at educational events from Shionogi and has received travel support from Shionogi and Menarini for scientific purposes. Herrera S has received speaking and lecture fees and travel reimbursement from Pfizer Inc., speaking and lecture fees from Shionogi and travel reimbursement from Menarini. Los-Arcos I has received honoraria for speaking at educational events from MSD, Pfizer and Shionogi and has received travel support from Gilead, MSD, Shionogi, Mundipharma and Menarini for scientific purposes. Castón JJ has received research grants from Pfizer and Menarini and honoraria for educational activities from Pfizer, Menarini, Shionogi and MSD. Fernández-Ruiz M has received honoraria for presentations from Pfizer and MSD. Len O has received honoraria for presentations from Shionogi and Pfizer, and research funding from Pfizer and MSD. Machuca I has received research grants from Shionogi and Merck Sharp and Dohme (MSD). Martínez-Martínez L has been a consultant for MSD, Shionogi, Fastinov, and Pfizer, has served as speaker for Pfizer, MSD, Astra-Zeneca, Astellas, Menarini, Roche, and Shionogi, and has received research support from Pfizer, MSD, Janssen-Cilag, Shionogi, and Advanz. López-Medrano F has received speaking and lecture fees and travel reimbursement from Pfizer Inc., Shionogi and MSD. Rodríguez-Gómez J has received lecture fees from MSD. Aguado JM has been a consultant to and on the speakers´ bureau for Pfizer, Shionogi, Advanz, and MSD. The remaining authors do not declare conflict of interest.

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