Vancomycin-resistant Enterococcus in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

Clin Transplant. 2019 Sep;33(9):e13549. doi: 10.1111/ctr.13549. Epub 2019 May 7.

Abstract

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation address vancomycin-resistant enterococci (VRE) infections in SOT candidates and recipients. VRE are an important cause of infection and have been named by the CDC as a serious public threat. Typically, a commensal of the gastrointestinal tract, VRE may become pathogenic after abdominal organ manipulation like transplantation. This guideline reviews the microbiology, antimicrobial resistance mechanisms, epidemiology, and clinical manifestations of VRE infection in the context of solid organ transplantation. Treatment regimens including combination therapies and novel investigational agents are also reviewed. Finally, an updated appraisal of infection control measures relevant to VRE infection and colonization is presented.

Keywords: antibiotic resistance; enterococcus; transplantation.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Gram-Positive Bacterial Infections / diagnosis*
  • Gram-Positive Bacterial Infections / drug therapy*
  • Gram-Positive Bacterial Infections / etiology
  • Humans
  • Organ Transplantation / adverse effects*
  • Practice Guidelines as Topic / standards*
  • Societies, Medical
  • Transplant Recipients
  • Vancomycin / pharmacology
  • Vancomycin-Resistant Enterococci / isolation & purification*

Substances

  • Anti-Bacterial Agents
  • Vancomycin