title: Multidrug-resistant organisms in liver transplant: Mitigating risk and managing infections.
abstract: Liver transplant (LT) recipients are vulnerable to infections with multidrug-resistant (MDR) pathogens. Risk factors for colonization and infection with resistant bacteria are ubiquitous and unavoidable in transplantation. During the past decade, progress in transplantation and infection prevention has contributed to the decreased incidence of infections with methicillin-resistant Staphylococcus aureus. However, even in the face of potentially effective antibiotics, vancomycin-resistant enterococci continue to plague LT. Gram-negative bacilli prove to be more problematic and are responsible for high rates of both morbidity and mortality. Despite the licensure of novel antibiotics, there is no universal agent available to safely and effectively treat infections with MDR gram-negative organisms. Currently, efforts dedicated toward prevention and treatment require involvement of multiple disciplines including transplant providers, specialists in infectious diseases and infection prevention, and researchers dedicated to the development of rapid diagnostics and safe and effective antibiotics with novel mechanisms of action. Liver Transplantation 22 1143-1153 2016 AASLD.
authors.affiliation: Department of Infectious Diseases, Ochsner Clinic Foundation, The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hand
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Gopi
authors.initials: G
authors.lastname: Patel
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000517:prevention & control; D003428:Cross Infection / Q000188:drug therapy / Q000517:prevention & control; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D006090:Gram-Negative Bacteria / Q000302:isolation & purification / Q000502:physiology*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D006094:Gram-Positive Bacteria / Q000302:isolation & purification / Q000502:physiology*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents