부산대학교 도서관

Background: Performance of active screening for multidrug‐resistant Gram‐negative bacteria (MDR‐GNB) and administration of targeted antibiotic prophylaxis (TAP) in colonized patients undergoing liver (LT) and/or kidney transplantation (KT) are controversial issues. Methods: Self‐administered electronic cross‐sectional survey disseminated from January to February 2022. Questionnaire consisted of four parts: hospital/transplant program characteristics, standard screening and antibiotic prophylaxis, clinical vignettes asking for TAP in patients undergoing LT and KT with prior infection/colonization with four different MDR‐GNB (extended‐spectrum cephalosporin‐resistant Enterobacterales [ESCR‐E], carbapenem‐resistant Enterobacterales [CRE], multidrug‐resistant Pseudomonas aeruginosa [MDR‐Pa], and carbapenem‐resistant Acinetobacter baumannii [CRAb]). Results: Fifty‐five respondents participated from 14 countries, mostly infectious disease specialists (69%) with active transplant programs (>100 procedures/year for 34.5% KT and 23.6% LT), and heterogeneous local MDR‐GNB prevalence from <15% (30.9%), 15%–30% (43.6%) to >30% (16.4%). The frequency of screening for ESCR‐E, CRE, MDR‐Pa, and CRAb was 22%, 54%, 17%, and 24% for LT, respectively, and 18%, 36%, 16%, and 11% for KT. Screening time‐points were mainly at transplantation 100%, only one‐third following transplantation. Screening was always based on rectal swab cultures (100%); multi‐site sampling was reported in 40% of KT and 35% of LT. In LT clinical cases, 84%, 58%, 84%, and 40% of respondents reported TAP for prior infection/colonization with ESCR‐E, CRE, MDR‐Pa, and CRAb, respectively. In KT clinical cases, 55%, 39%, 87%, and 42% of respondents reported TAP use for prior infection/colonization with ESCR‐E, CRE, MDR‐Pa, and CRAb, respectively. Conclusion: There is a large heterogeneity in screening and management of MDR‐GNB carriage in LT and KT. [ABSTRACT FROM AUTHOR]