title: The Bacteremia Caused by Non-Lactose Fermenting Gram-Negative Bacilli in Solid Organ Transplant Recipients.
abstract: BACKGROUND
  Blood stream infections (BSIs) remain as a serious life-threatening condition after solid organ transplant (SOT). In recent years, a progressive growth in the incidence of bacteremia caused by non-lactose fermenting gram-negative bacilli (NLF GNB) has been observed. NLF GNB led to high mortality among SOT recipients with bacteremia and were difficult to treat because of their high drug resistance to commonly used antibiotics.
  
  
  METHODS
  Two electronic databases, PUBMED and EMBASE, were searched for relevant literature published up to January 2015, to better understand the characteristics of bacteremia because of NLF GNB.
  
  
  RESULTS
  The morbidity and mortality rates of bacteremia because of NLF GNB depend on the types of organisms and transplantation. Multi-drug resistant NLF GNB ranged from 9.8% to 12.5% of all NLF GNB causing BSIs among SOT recipients. Certain factors can predispose SOT recipients to NLF GNB bacteremia, which included previous transplantation, hospital-acquired BSIs, and prior intensive care unit admission. Combination therapy may be beneficial in the treatment of NLF GNB bacteremia to enhance antimicrobial activity, provide synergistic interactions, relieve side effects, and minimize superinfections.
  
  
  CONCLUSIONS
  Prevention is pivotal in minimizing the morbidity and mortality associated with NLF GNB bacteremia after SOT. To improve the outcomes of SOT recipients with NLF GNB bacteremia, prevention is pivotal, and combination therapy of antibiotics may be beneficial.
authors.affiliation: 1 Department of Transplant Surgery, The Third Xiangya Hospital, Central South University , Changsha, Hunan, China .
authors.forename: Qiquan
authors.initials: Q
authors.lastname: Wan
authors.affiliation: 1 Department of Transplant Surgery, The Third Xiangya Hospital, Central South University , Changsha, Hunan, China .|2 Department of Transplant Surgery, Zhongnan Hospital, Wuhan University , Wuhan, China .
authors.forename: Qifa
authors.initials: Q
authors.lastname: Ye
authors.affiliation: 3 Department of General Surgery, The Third Xiangya Hospital, Central South University , Changsha, China .
authors.forename: Feizhou
authors.initials: F
authors.lastname: Huang
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D005285:Fermentation; D006088:Gram-Negative Aerobic Bacteria / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D006801:Humans; D007785:Lactose / Q000378:metabolism; D016377:Organ Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D015995:Prevalence; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D007785:Lactose