{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T07:48:51Z","timestamp":1776930531809,"version":"3.51.2"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000765","name":"University College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000765","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A patient with an extensively drug\u2010resistant (XDR) New Delhi metallo\u2010\u03b2\u2010lactamase (NDM) and oxacillinase (OXA\u201048) producing <jats:italic>Escherichia coli (E. coli<\/jats:italic>) infection was awaiting orthotopic liver transplant. There is no standardized antibiotic prophylaxis regimen; however, in line with the Infectious Diseases Society of America guidance, an antibiotic prophylactic regimen of ceftazidime\u2010avibactam 2.5\u00a0g TDS with aztreonam 2\u00a0g three times a day (TDS) IV was proposed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The hollow fiber system (HFS) was applied to inform the individualized pharmacodynamic outcome likelihood prior to prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A 4\u2010log reduction in CFU\/mL in the first 10 h of the regimen exposure was observed; however, the killing dynamics were slow and six 8\u2010hourly infusions were required to reduce bacterial cells to below the limit of quantification. Thus, the HFS supported the use of the regimen for infection clearance; however, it highlighted the need for several infusions. Standard local practice is to administer prophylaxis antibiotics at induction of orthotopic liver transplantation (OLT); however, the HFS provided data to rationalize earlier dosing. Therefore, the patient was dosed at 24 h prior to their OLT induction and subsequently discharged 8 days after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The HFS provides a dynamic culture solution for informing individualized medicine by testing antibiotic combinations and exposures against the bacterial isolates cultured from the patient's infection.\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\/tid14396-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14396","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T12:19:00Z","timestamp":1730722740000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Personalized CZA\u2010ATM dosing against an XDR <i>E. coli<\/i> in liver transplant patients; the application of the in vitro hollow fiber system"],"prefix":"10.1111","volume":"27","author":[{"given":"Zahra","family":"Sadouki","sequence":"first","affiliation":[{"name":"Institute for Global Health University College London  London UK"},{"name":"Centre of Clinical Microbiology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2985-9524","authenticated-orcid":false,"given":"Emmanuel Q.","family":"Wey","sequence":"additional","affiliation":[{"name":"Centre of Clinical Microbiology University College London  London UK"},{"name":"Department of Infection Royal Free London NHS Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satheesh","family":"Iype","sequence":"additional","affiliation":[{"name":"Department of HPB and Liver Transplant Surgery, Royal Free Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Nasralla","sequence":"additional","affiliation":[{"name":"Department of HPB and Liver Transplant Surgery, Royal Free Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Potts","sequence":"additional","affiliation":[{"name":"Department of Hepatology Sheila Sherlock Liver Unit Royal Free London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Spiro","sequence":"additional","affiliation":[{"name":"Department of Surgical Biotechnology University College London  London UK"},{"name":"Department of Intensive Care Medicine Royal Free London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Infection Sciences Health Services Laboratories  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy D.","family":"McHugh","sequence":"additional","affiliation":[{"name":"Centre of Clinical Microbiology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7213-4559","authenticated-orcid":false,"given":"Frank","family":"Kloprogge","sequence":"additional","affiliation":[{"name":"Institute for Global Health University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001848"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13589"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14631"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00811-8"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11040427"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkab160"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae403"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa586"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz1155"},{"key":"e_1_2_8_11_1","volume-title":"M100: Performance Standards for Antimicrobial Susceptibility Testing","author":"CLSI","year":"2023"},{"key":"e_1_2_8_12_1","unstructured":"Aranzana\u2010ClimentV ChauzyA Gr\u00e9goireN.HF\u2010App: A R\u2010Shiny application to streamline hollow\u2010fibre experiments. 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