Solid organ transplant antibiograms: an opportunity for antimicrobial stewardship

- Multi-drug resistant Gram-negative rods are frequent among transplant recipients.
- Hospital-wide antibiograms may not reflect bacterial resistance in these patients.
- Development of antibiograms specific for this high-risk population is proposed.
- Antimicrobial stewardship activities can be improved by using this approach.

ObjectivesWe aimed to compare the antimicrobial susceptibility percentages in blood and urine bacterial isolates recovered from solid organ transplant (SOT) recipients with those reported in the hospital-wide antibiogram.MethodsRetrospective review of the antimicrobial susceptibilities of bacterial isolates recovered from SOT recipients at a 1550-bed hospital over a 2-year period. Antibiograms were categorized by anatomic site (blood and urine). Percentage of bacterial susceptibilities to specific antibiotics were compared with the hospital-wide antibiogram.ResultsA total of 1889 unique cultures were identified. Blood and urine isolates of Escherichia coli, Klebsiella pneumonia and Pseudomonas aeruginosa had significantly lower susceptibility to first and second line antibiotics compared to the hospital-wide antibiogram.ConclusionSignificant differences in susceptibilities between isolates from blood and urine cultures from SOT recipients and the hospital-wide antibiogram were found. A population-based strategy for the development of antibiograms specific for this group of high-risk patients could better guide appropriate empiric antimicrobial selection.