Brazilian perspective: antimicrobial stewardship in solid organ transplant.

Autor: Porto APM; Hospital de Messejana Dr Carlos Alberto Studart, Ceará, Brazil.; LIM-49 Instituto de Medicina Tropical da Universidade de São Paulo, Sao Paulo, Brazil., Tavares BM; LIM-49 Instituto de Medicina Tropical da Universidade de São Paulo, Sao Paulo, Brazil.; Grupo de Controle de Infecção, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Bazil.; Hospital Alemão Oswaldo Cruz, Sao Paulo, Brazil., de Assis DB; Divisão de Infecções Hospilatares, Centro de Vigilancia Epidemiologica 'Prof. Alexandre Vranjac', Centro de Controle de Doencas, Secretaria de Estado da Saude, Sao Paulo, Brazil., Mendes ET; Pontifical Catholic University of Campinas (PUC Campinas), Center for Life Sciences, Postgraduate Program in Health Sciences, Campinas, Sao Paulo, Brazil., Girão ES; Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Ceará, Brazil., Perdigão Neto LV; Hospital São Jose de Doenças Infecciosas, Ceará, Brazil., Falcão MAP; Pharmacy Division, Instituto Central of Hospital das Clínicas, University of São Paulo, Sao Paulo, Brazil., de Oliveira MS; Grupo de Controle de Infecção, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Bazil., Freire MP; Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil., Guimaraes T; Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.; Hospital do Servidor Público Estadual, São Paulo, Sao Paulo, Brazil., Arantes T; Pharmacy Division, Instituto Central of Hospital das Clínicas, University of São Paulo, Sao Paulo, Brazil., Levin AS; Grupo de Controle de Infecção, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Bazil.; Infectious Diseases Department, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil., Costa SF; LIM-49 Instituto de Medicina Tropical da Universidade de São Paulo, Sao Paulo, Brazil.; Infectious Diseases Department, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Transplant infectious disease : an official journal of the Transplantation Society [Transpl Infect Dis] 2022 Oct; Vol. 24 (5), pp. e13874.
DOI: 10.1111/tid.13874
Abstrakt: Background: The incidence of multidrug resistant organisms (MDROs) infections among solid organ transplant (SOT) patients is very high in Brazil.
Methods: This review will discuss antimicrobial use and resistance in SOT in Brazil, highlighting the main barriers and facilitators for implementation of an antimicrobial stewardship programme (ASP).
Results: The most common group of MDROs is carbapenem-resistant Gram-negative bacteria and vancomycin-resistant Enterococcus. Carbapenem-resistant Enterobacterales (CREs) are the most frequent MDROs and have been reported as donor-derived as well. Although ASPs are mandatory in the country, there is a lack of information regarding ASPs in SOT recipients. The main barriers for the implementation of ASPs in Brazilian hospitals are lack of electronic medical records, absence of national guidelines specific to SOT recipients, lack of recommendations on surveillance culture to evaluate colonization and transmission of donor-derived MDROs, limited availability of rapid diagnostic tests, and insufficient pharmacist and clinician time allocated to ASP activities in some SOT centers.
Conclusions: The incidence of MDRO infections caused mainly by VREs and CREs is very high in the country. There is limited data regarding antimicrobial use among SOT recipients in Brazil. The absence of antimicrobial stewardship national guidelines specific to SOT recipients is one of the main barriers for the implementation of ASPs in Brazilian hospitals.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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