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Carbapenemase-producing organisms in solid organ transplantation

Wong, Darrena; van Duin, Davidb

Current Opinion in Organ Transplantation: August 2019 - Volume 24 - Issue 4 - p 490–496
doi: 10.1097/MOT.0000000000000664
INFECTIOUS DISEASES: Edited by Emily Blodget
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Purpose of review Carbapenem-resistant enterobacteriaceae (CRE) are a critical healthcare threat. Infections caused by CRE disproportionately affect transplant patients. Retrospective case studies suggest that up to 10% of transplant recipients develop a CRE infection. The current literature is reviewed with a particular focus on transplant-specific implications.

Recent findings There are specific risks inherent to transplant recipients that result in an elevated risk for CRE carriage and subsequent infection. Additionally, the manifestations of these infections are dependent on the specific transplant type. The optimal treatment of CRE infections in transplant recipients has not been defined.

Summary A reduction in the regional community CRE burden can lead to a secondary reduction in their occurrence within vulnerable transplant populations. Therefore, core principles of antibiotic stewardship and infection control within all levels of the healthcare system remains the most effective strategy for addressing the current health crisis. Simultaneously, an integrated approach to risk stratification and an approach to treatment is postulated for management of CRE infection within the solid-organ transplant population.

aDivision of Infectious Diseases, Keck School of Medicine at the University of Southern California (USC), Los Angeles, California

bDivision of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA

Correspondence to Darren Wong, MD, Division of Infectious Diseases, Keck School of Medicine at the University of Southern California (USC), Los Angeles, California, USA. Tel: +1 323 409 4397; e-mail: darrenww@med.usc.edu

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