Publication

Approach to multidrug resistant infections in pediatric transplant recipients

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Last modified
  • 01/14/2026
Type of Material
Authors
    Sara W. Dong, Emory UniversityTanvi S. Sharma, Boston Children's HospitalPaul K. Sue, Columbia University
Language
  • English
Date
  • 2023-12-07
Publisher
  • Frontiers
Publication Version
Copyright Statement
  • © 2023 Dong, Sharma and Sue.
License
Final Published Version (URL)
Title of Journal or Parent Work
Volume
  • 11
Start Page
  • 1270564
Grant/Funding Information
  • The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
Abstract
  • Introduction There is increasing recognition of infections due to multidrug-resistant Gram negative (MDRGN) bacterial infections among children undergoing solid organ and hematopoietic cell transplantation, which may be associated with morbidity and mortality. Methods We present two vignettes that highlight the clinical challenges of evaluation, management, and prevention of MDRGN bacterial infections in children prior to and after transplantation. The goal of this discussion is to provide a framework to help develop an approach to evaluation and management of these infections. Results Source control remains the utmost priority in management of MDR infections and is paired with antibiotic selection guided by in vitro susceptibilities, adverse effect profiles, and clinical response. Identification and confirmation of resistance can be challenging and often requires additional testing for recognition of complex mechanisms. Current antimicrobial approaches to MDRGN infections include use of novel agents, prolonged infusion, and/or combination therapy. We also discuss preventative efforts including infection control, antimicrobial stewardship, targeted pre-emptive or prophylactic treatment, and decolonization. Discussion The impact of MDRGN infections on patient and graft survival highlights the need to optimize treatment and prevention strategies.
Author Notes
  • Competing interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
  • Correspondence: Sara W. Dong sara.winn.dong@emory.edu
  • Author contributions: SD: Conceptualization, Writing – original draft, Writing – review and editing. TS: Conceptualization, Writing – original draft, Writing – review and editing. PS: Conceptualization, Writing – original draft, Writing – review and editing.
Keywords
Subject - Topics
  • Transplantation
  • Pediatrics

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