Antimicrobial Prophylaxis in Solid Organ and Hematopoietic Stem Cell Transplantation: A Survey Among Member Centers of the European Reference Network TransplantChild.
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Donà Daniele, Liberati Cecilia, Aidala Enrico, Bekassy Zivile, Bjerre Anna, Bordon Victoria, Sanchez David Bueno, Bouts Antonia H M, Bravo-Gallego Luz Yadira, Casotti Valeria, Catalano Silvia, Costa-Reis Patricia, Cucinotta Ugo, Debray Dominique, De Jong Huib, De la Cerda-Ojeda Francisco, De la Serna Olga, Ferreira Sandra, Fischler Björn, Guereta Luis García, Gil Nuria, Vincent Marta González, Gran-Ipiña Ferran, Grenda Ryszard, Grima Daniela, Herden Uta, Hierro Maria Loreto, Huerta Jorge, Jahnukainen Timo, Jankauskiene Augustina, Kaliciński Piotr, Kötz Karsten, Lopes Maria Francelina, Gonzales Mercedes Lopez, Madrid Álvaro, Mercadal-Hally Maria, Marsal Julia, Marzollo Antonio, Mellgren Karin, Mendoza-Palomar Natalia, Mutschler Frauke, Odermarsky Michal, De Mendoza José María Pérez-Hurtado, Peruzzi Licia, Pietrobattista Andra, Pinon Michele, Prytula Agnieszka, Ramos Esther Boluda, Ranucci Giusy, Rascon Jelena, Saglio Francesco, Sandes Ana Rita, Sciveres Marco, Schwerk Nicolaus, Sharif Kalid, Sørensen Søren Schwartz, Stephenne Xavier, Sweeney Clodagh, Texeira Ana, Tepel Martin, Turkiewicz Dominik, Vainumae Inga, Verma Anita, Wåhlander Håkan, Warrington Adriana, Wennberg Lars, Westphal Susanne, Willemse Brigitte W M, Wolfs Tom, Zarauza Alejandro, Benetti Elisa, Oliveros Francisco Hernández-, ERN‐TransplantChild
Аннотация
METHODS: Between December 2022 and February 2023, healthcare professionals within the network completed a structured survey addressing microbiological screening practices and peri-transplant antimicrobial strategies in pediatric transplant recipients.
RESULTS: Of 127 transplant programs invited, 76 (59.8%) responded, including 62 SOT and 14 HSCT programs from 36 centers across 16 European countries. Pre-transplant screening strategies, microbiological methods, and decolonization practices varied substantially between centers. Reported prevalence of methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase-producing organisms was below 10% in most programs. In SOT, perioperative prophylaxis varied according to transplanted organ type. Cephalosporins were most commonly used in kidney and heart transplantation, whereas broader-spectrum regimens, including piperacillin-tazobactam and vancomycin, were more frequently adopted in liver, intestinal, and lung transplantation. Postoperative prophylaxis was continued beyond 24 h in most SOT programs. Antifungal prophylaxis was more commonly adopted in liver, intestinal, and lung transplant recipients. In HSCT, antibacterial peri-transplant use was not routinely prescribed in a substantial proportion of programs, particularly in autologous transplantation, whereas antifungals were widely used in allogeneic HSCT.
CONCLUSIONS: Marked heterogeneity in microbiological screening and peri-transplant antimicrobial strategies across European pediatric transplant centers underscores the need for transplant-specific, evidence-based guidelines distinguishing between SOT and HSCT settings. These findings provide a foundation for the development of shared clinical pathways and harmonized recommendations.