{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T22:52:43Z","timestamp":1775947963084,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of antimicrobial agents in the preservation solution (PS) could prevent the bacterial transmission to recipients in organ transplantation. However, antibiotics may exhibit different decontamination efficacy in the hypothermic PS. This study aimed to evaluate the antibacterial activity of ceftazidime\u2010avibactam (CAZ\u2010AVI) combined with aztreonam (ATM) against multidrug\u2010resistant bacteria (MDRB) at varying ratios and concentrations during 3\u00a0h, 0\u00b0C\u20134\u00b0C PS decontamination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An in vitro model simulating PS decontamination was established. Five MDRB isolates were collected and tested (CRKP, CRPA, CREC, CRAB, and MRSA). CAZ\u2010AVI and ATM were prepared at different ratios (1:1, 1:2, 1:4, 2:1) and concentration gradients (0.5\u00d7, 1\u00d7, 2\u00d7, 4\u00d7 the baseline). Antibacterial efficacy was recorded and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For CRKP and CREC, the 2:1 ratio at 0.5\u00d7 concentration (250\u00a0mg\/L CAZ\u2010AVI\u00a0+\u00a00.5\u00a0g\/L ATM) showed significant antibacterial effects (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.002 and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001, respectively). For CRPA, efficacy was observed at the 1\u00d7 concentration with a 2:1 ratio (500\u00a0mg\/L CAZ\u2010AVI\u00a0+\u00a01.0\u00a0g\/L ATM;\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.022), while for CRAB, the 1:1 ratio at 0.5\u00d7 concentration (125\u00a0mg\/L CAZ\u2010AVI\u00a0+\u00a00.5\u00a0g\/L ATM;\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.001) was effective. The combination was only effective against MRSA at high concentrations (1000\u00a0mg\/L CAZ\u2010AVI\u00a0+\u00a02.0\u00a0g\/L ATM;\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The combination of CAZ\u2010AVI and ATM effectively decontaminates MDR Gram\u2010negative bacteria in PS. The 2:1 ratio at baseline concentration is recommended for clinical use, with potential escalation of CAZ\u2010AVI concentration if needed.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid70157-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70157","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T08:42:58Z","timestamp":1766738578000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Study on the Antibacterial Efficacy of Ceftazidime\u2010Avibactam Combined With Aztreonam against Multidrug\u2010Resistant Bacteria in Hypothermic Organ Preservation Solution"],"prefix":"10.1111","volume":"28","author":[{"given":"Yazhe","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Organ Transplantation Shanghai Changhai Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daqian","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Shanghai Changhai Hospital  Shanghai China"},{"name":"Department of Urology No. 908th Hospital of Chinese PLA Joint Logistic Support Force  Nanchang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Shanghai Changhai Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7033-4158","authenticated-orcid":false,"given":"Pei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Shanghai Changhai Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxiang","family":"Wan","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Shanghai Changhai Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kang","family":"Wu","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Shanghai Changhai Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanfeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Shanghai Changhai Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junhao","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Shanghai Changhai Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenyu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Shanghai Changhai Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanhua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Shanghai Changhai Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7981-794X","authenticated-orcid":false,"given":"Mingxing","family":"Sui","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Shanghai Changhai Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation Shanghai Changhai Hospital  Shanghai 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