Call for antimicrobial stewardship in solid organ transplantation.

摘要: To the Editor:We read with interest recently published InfectiousDisease Guidelines of American Society Transplan-tation (AST), and commend Infectious DiseasesCommunity Practice for timely release thesecomprehensive guidelines (1). We are disappointed,however, to see that a cohesive approach developingan antimicrobial stewardship program (ASP) within thetransplant community was not described. ASPs can have apositive impact on limiting prevalence multidrugresistant (MDR) infections, focus several newguidelines. Transplant recipients disproportionatelyaffected by MDR bacteria, prolonged exposure tobroad-spectrum agents often present as thesole risk factor their development (2).Numerous studies shown various stewardshipinterventions able decrease inappropriate use ofantimicrobialsandlimittheriseofresistantbacteriawithoutaconcomitant decline in clinical outcomes (3). While theimpact transplant-specific population has notbeen formally evaluated, hospital-level multicenterstudies evaluating frequently includesolid organ transplant part targetpopulation. Additionally, benefit therise bacteria may extend collateral totransplant patients, admission rooms werepreviouslyoccupiedbypatientscolonizedwithMDRbacteriahas been be an independent theacquisition subsequent patients (4).The Diseases America, forHealthcare Epidemiology America Pediatric Infec-tious released positionstatement calling mandatory implementation ASPsthroughout healthcare system (5). believe is key stakeholder this mandate,serving patient likely derive thegreatest from its implementation. Through formalguidance recommendations members theimplementation stewardship, we believethat AST lasting, positive well-being it serves. call upon adoptcomprehensive tofurther goal.S. L. Aitken