{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T14:48:58Z","timestamp":1783608538446,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T00:00:00Z","timestamp":1602028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Infections caused by multidrug\u2010resistant gram\u2010negative bacilli (GNB) cause significant morbidity and mortality in solid organ transplant (SOT) recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively collected data from all SOT recipients at a single center from 1 January 2007 to 15 April 2017 treated for infections caused by multi\u2010drug\u2010resistant GNB. This study examined the effects of specific antibiotics on nephrotoxicity, neurotoxicity, 30\u2010day mortality, and length of stay in the hospital and intensive care unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 225 infections were identified among 143 patients. Carbapenem\u2010sensitive organisms were present in 112 (49.8%) infections and were associated with decreased 30\u2010day mortality (OR 0.35, 95% CI 0.16\u20100.75). Neurotoxicity was associated with polymyxin use with an 8% increase in odds of neurotoxicity per day of exposure (<jats:italic>P<\/jats:italic>=.03). There was no relationship between nephrotoxicity and any individual antibiotic class. Increased hospital length\u2010of\u2010stay occurred among patients exposed to aminoglycosides (\u03b2\u2010statistic\u00a0=\u00a00.48 (0.23); <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04), while there was no relationship between antibiotic class and intensive care unit (ICU) length\u2010of\u2010stay. Mortality at 30\u00a0days occurred in 37 infections (16%). Carbapenem exposure was associated with decreased 30\u2010day mortality (OR 0.93; 95% CI 0.90\u20100.98; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02). No other antibiotic class had a significant impact on 30\u2010day mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Carbapenems appear to be a safe and effective treatment for solid\u2010organ transplant recipients with infections caused by carbapenem\u2010sensitive multidrug\u2010resistant GNB; treatment of carbapenem\u2010resistant gram\u2010negatives remains challenging.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13474","type":"journal-article","created":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T03:13:57Z","timestamp":1601090037000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Treatment of multidrug\u2010resistant gram\u2010negative bacilli after solid organ transplant: Outcomes and complications"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9424-1870","authenticated-orcid":false,"given":"Madeleine R.","family":"Heldman","sequence":"first","affiliation":[{"name":"Division of Allergy and Infectious Diseases Department of Medicine University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kexin","family":"Guo","sequence":"additional","affiliation":[{"name":"Comprehensive Transplant Center Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Nelson","sequence":"additional","affiliation":[{"name":"Rosalind Franklin University of Medicine and Science North Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tenzin","family":"Babu","sequence":"additional","affiliation":[{"name":"University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3347-9671","authenticated-orcid":false,"given":"Michael G.","family":"Ison","sequence":"additional","affiliation":[{"name":"Comprehensive Transplant Center Northwestern University Feinberg School of Medicine Chicago IL USA"},{"name":"Divisions of Infectious Diseases and Organ Transplantation Northwestern University Feinberg School of Medicine Chicago IL 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