Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate´s phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection.J.T.S. holds a research contract from the Fundación para la Formación e Investigación de los Profesionales de la Salud de Extremadura (FundeSalud), Instituto de Salud Carlos III. M.F.R. holds a clinical research contract “Juan Rodés” (JR14/00036) from the Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III

Social problems /

World-crowding. By R. Giffen.--Europe in straits. Blackwood's magazine [v. 133, p. 438-450]--Secret societies in France. By Jehan de Paris.--Home rule, socialism, and secession. By J. W. Flanagan.--A democrat on the coming democracy. by H. Labouchere.--A politician in trouble about his soul. By A. Herbert.--The European terror. By E. de Laveleye.--The nationalization of the land. Edinburgh review [v. 157, p. 263-290]Mode of access: Internet

Systems of land tenure in various countries.

Longfield, M. Tenure of land in Ireland.--Hoskyns, C.W. Land-laws of England.--Campbell. G. Tenure of land in India.--Laveleye, E. de. Land system of Belgium and Holland.--Morier, R.B.D. Agrarian legislation of Prussia during the present century.--Leslie, T.C. Land system of France.--Faucher. J. Russian agrarian legislation of 1861.--Fisher. C.M. Farm land and land-laws of the United States.Mode of access: Internet

Systems of land tenure in various countries. A series of essays published under the sanction of the Cobden Club.

Includes index.Longfield, M. The tenure of land in Ireland.--Brodrick, G. C. The law and custom of primogeniture.--Hoskyns, C. W. The land laws of England.--Campbell, Sir G. The tenure of land in India.--Leslie, T. E. C. The land system of France.--Faucher, J. The Russian agrarian legislation of 1861.--Morier, R. B. D. The agrarian legislation of Prussia during the present century; also a report on the tenure of land in the grand duchy of Hesse.--Laveleye, É. de. The land system of Belgium and Holland.--Fisher, C. M. Farm land and land laws of the United States.Mode of access: Internet