{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:06:17Z","timestamp":1785323177017,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"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":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Antimicrobial misuse contributes to antimicrobial resistance in thoracic transplant (TTx) and mechanical circulatory support (MCS) recipients. This study uses a modified Delphi method to define the expected appropriate antimicrobial prescribing for the common clinical scenarios encountered in TTx and MCS recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An online questionnaire on managing 10 common infectious disease syndromes was submitted to a multidisciplinary Delphi panel of 25 experts from various disciplines. Consensus was predefined as 80% agreement for each question. Questions where consensus was not achieved were discussed during live virtual live sessions adapted by an independent process expert.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An online survey of 62 questions related to 10 infectious disease syndromes was submitted to the Delphi panel. In the first round of the online questionnaire, consensus on antimicrobial management was reached by 6.5% (4\/62). In Round 2 online live discussion, the remaining 58 questions were discussed among the Delphi Panel members using a virtual meeting platform. Consensus was reached among 62% (36\/58) of questions. Agreement was not reached regarding the antimicrobial management of the following six clinical syndromes: (1) <jats:italic>Burkholderia cepacia<\/jats:italic> pneumonia (duration of therapy); (2) <jats:italic>Mycobacterium abscessus<\/jats:italic> (intra\u2010operative antimicrobials); (3) invasive aspergillosis (treatment of culture\u2010negative but positive BAL galactomannan) (duration of therapy); (4) respiratory syncytial virus (duration of antiviral therapy); (5) left ventricular assist device deep infection (initial empirical antimicrobial coverage) and (6) CMV (duration of secondary prophylaxis).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This Delphi panel developed consensus\u2010based recommendations for 10 infectious clinical syndromes seen in TTx and MCS recipients.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14251-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14251","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T04:54:08Z","timestamp":1707886448000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Management of infectious disease syndromes in thoracic organ transplants and mechanical circulatory device recipients: a Delphi panel"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3756-892X","authenticated-orcid":false,"given":"Me\u2010Linh","family":"Luong","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases CHUM  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiko","family":"Nakamachi","sequence":"additional","affiliation":[{"name":"University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda P.","family":"Silveira","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of Pittsburgh and UPMC  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine O.","family":"Morrissey","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Alfred Health and Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5691-5221","authenticated-orcid":false,"given":"Lara","family":"Danziger\u2010Isakov","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Infectious Diseases Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik A. 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