Multidrug-resistant organisms in liver transplant: Mitigating risk and managing infections

Liver Transpl. 2016 Aug;22(8):1143-53. doi: 10.1002/lt.24486.


Liver transplant (LT) recipients are vulnerable to infections with multidrug-resistant (MDR) pathogens. Risk factors for colonization and infection with resistant bacteria are ubiquitous and unavoidable in transplantation. During the past decade, progress in transplantation and infection prevention has contributed to the decreased incidence of infections with methicillin-resistant Staphylococcus aureus. However, even in the face of potentially effective antibiotics, vancomycin-resistant enterococci continue to plague LT. Gram-negative bacilli prove to be more problematic and are responsible for high rates of both morbidity and mortality. Despite the licensure of novel antibiotics, there is no universal agent available to safely and effectively treat infections with MDR gram-negative organisms. Currently, efforts dedicated toward prevention and treatment require involvement of multiple disciplines including transplant providers, specialists in infectious diseases and infection prevention, and researchers dedicated to the development of rapid diagnostics and safe and effective antibiotics with novel mechanisms of action. Liver Transplantation 22 1143-1153 2016 AASLD.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Catheter-Related Infections / drug therapy
  • Catheter-Related Infections / prevention & control
  • Cross Infection / drug therapy
  • Cross Infection / prevention & control
  • Disease Transmission, Infectious / prevention & control
  • Drug Resistance, Multiple, Bacterial*
  • Drug Therapy, Combination
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Negative Bacteria / physiology*
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / epidemiology
  • Gram-Negative Bacterial Infections / microbiology
  • Gram-Negative Bacterial Infections / prevention & control
  • Gram-Positive Bacteria / isolation & purification
  • Gram-Positive Bacteria / physiology*
  • Gram-Positive Bacterial Infections / drug therapy*
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / microbiology
  • Gram-Positive Bacterial Infections / prevention & control
  • Humans
  • Incidence
  • Liver Transplantation / adverse effects*
  • Risk Factors


  • Anti-Bacterial Agents