RESUMO
Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection.
Assuntos
Antibacterianos/uso terapêutico , Gerenciamento Clínico , Resistência a Múltiplos Medicamentos , Infecções por Bactérias Gram-Negativas , Transplante de Órgãos , Doadores de Tecidos , Transplantados , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/etiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Complicações Pós-OperatóriasRESUMO
No disponible
Assuntos
Humanos , Intoxicação Alimentar por Cogumelos/complicações , Injúria Renal Aguda/etiologia , Cortinarius/patogenicidade , Agaricus vernus/toxicidadeRESUMO
No disponible
Assuntos
Humanos , Intoxicação Alimentar por Cogumelos/complicações , Insuficiência Renal/etiologia , Fatores de RiscoRESUMO
Two cases of Pseudomembranous Colitis are presented in old aged people with multi-systematic failure (renal, respiratory, cardiac) doing mention of favorable circumstances, of the clinic, of the physiopathological hypothesis of the diagnostic and therapeutical ways. They get to the conclusion of the easiness of the development in old people because of their precarious "vascularization" and the need of a systematic study of diarrhea in advanced ages, even though the picture seems simple.
