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Clin Transplant. 2019 May 11:e13589. doi: 10.1111/ctr.13589. [Epub ahead of print]

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

Author information

1
Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine and Jackson Health System, Miami, Florida.
2
Infectious Diseases Section, Department of Medicine and Surgery, University of Insubria, Varese, Italy.

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.

KEYWORDS:

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

PMID:
31077619
DOI:
10.1111/ctr.13589

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