Surgical site infections: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

the AST ID Community of Practice

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Abstract

These guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of post-operative surgical site infections (SSIs) in solid organ transplantation. SSIs are a significant cause of morbidity and mortality in SOT recipients. Depending on the organ transplanted, SSIs occur in 3%-53% of patients, with the highest rates observed in small bowel/multivisceral, liver, and pancreas transplant recipients. These infections are classified by increasing invasiveness as superficial incisional, deep incisional, or organ/space SSIs. The spectrum of organisms implicated in SSIs in SOT recipients is more diverse than the general population due to other important factors such as the underlying end-stage organ failure, immunosuppression, prolonged hospitalizations, organ transportation/preservation, and previous exposures to antibiotics in donors and recipients that could predispose to infections with multidrug-resistant organisms. In this guideline, we describe the epidemiology, clinical presentation, differential diagnosis, potential pathogens, and management. We also provide recommendations for the selection, dosing, and duration of peri-operative antibiotic prophylaxis to minimize post-operative SSIs.

Original languageEnglish (US)
Article numbere13589
JournalClinical Transplantation
DOIs
StatePublished - Jan 1 2019

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Keywords

  • antibacterial
  • antibiotic
  • antibiotic prophylaxis
  • infection
  • infectious agents
  • solid organ transplantation
  • surgical infection

ASJC Scopus subject areas

  • Transplantation

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