The following is the summary of “Multidrug-resistant Enterobacterales infections in abdominal solid organ transplantation” published in the January 2023 issue of Clinical microbiology and infections by Pilmis, et al.

Multidrug-resistant (MDR) infections are a major threat to organ transplant patients. When metallo—lactamases are involved, the high death rate associated with MDR-related infections in transplant recipients may be attributable to a lack of early suitable antimicrobial treatment. This review summarizes the current body of knowledge on the prevention and treatment of infections caused by multidrug-resistant Gram-negative bacilli in patients who have undergone solid-organ transplantation. Researchers looked for research on the topic of managing infections caused by multidrug-resistant g-negative bacilli in recipients of renal and liver transplants. Both controlled experiments and naturalistic research were covered.

A solid organ transplant is the gold standard treatment for patients with terminal organ failure. The burden of “classical” infections attributable to MDR bacteria, notably due to Gram-negative bacteria, is constantly increasing, whereas the prevalence of opportunistic infections is decreasing due to better prophylaxis. The past 2 decades have seen an increase in the prevalence of infections caused by multidrug-resistant bacteria, or MDRs, among this population, which has been linked to high mortality rates. MDR infections are more common in transplant recipients due to several factors relating to donor and recipient care. Although its appropriateness can be evaluated retroactively, the significant sensitivity of transplant recipients to MDR-related illnesses poses a problem to the selection of empirical therapy.

Indeed, in the case of metallo-β-lactamases, the high mortality rate associated with MDR-related infections in transplant recipients may be attributable to the lack of early effective antimicrobial treatment. High rates of morbidity and mortality are seen in patients of solid organ transplants due to infections caused by multidrug-resistant Gram-negative bacteria. Patients at risk of colonization with MDR bacteria should be identified so that measures can be taken to reduce the likelihood of secondary infections and the unnecessary application of broad-spectrum antibiotics.

 Source: sciencedirect.com/science/article/abs/pii/S1198743X22003184