Transplant Infectious Disease最新文献

{"title":"Host and Pathogen Pharmacogenetics in Pneumocystis jirovecii Pneumonia After Kidney Transplantation: A Retrospective Cohort and Case-Control Study.","authors":"Nathalie Henskens, Katrien Lagrou, Henriette de Loor, Lize Cuypers, Dirk Kuypers","doi":"10.1111/tid.70257","DOIUrl":"10.1111/tid.70257","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant recipients are at risk for Pneumocystis jirovecii pneumonia (PJP), particularly under profound immunosuppression. Mycophenolic acid (MPA) is widely used after transplantation and is associated with interindividual variability in exposure and hematologic toxicity. Genetic variation affecting MPA metabolism and pharmacodynamics may contribute to lymphopenia and PJP.</p><p><strong>Methods: </strong>We performed a matched 1:2 case-control study to assess risk factors for PJP in kidney transplant recipients (1993-2022) using multivariable logistic regression. In addition, a retrospective cohort study restricted to PJP cases evaluated recipient polymorphisms in UGT1A9, IMPDH2, and IMPDH1, and their associations with bone marrow toxicity. P. jirovecii DNA from bronchoalveolar lavage samples was genotyped for IMPDH variants potentially associated with MPA resistance.</p><p><strong>Results: </strong>Thirty-nine PJP cases and 78 controls were included. Posttransplant cytomegalovirus infection and lymphopenia were independently associated with PJP. Among PJP cases, carriers of the IMPDH1 rs2278294 variant had a significantly higher incidence of lymphopenia, independent of MPA dose. P. jirovecii genotyping was obtained for 24 patients. The IMPDH Ala261Thr variant was detected in 16.7% and the Ala261Ser variant in 22.2% of MPA-treated patients, which is substantially lower than previously reported.</p><p><strong>Conclusions: </strong>In kidney transplant recipients with PJP, host genetic variation in IMPDH1, rather than polymorphisms affecting MPA metabolism, appears to be associated with lymphopenia and infection susceptibility. In contrast to prior reports, no clear enrichment of MPA resistance-associated P. jirovecii IMPDH variants was observed. These findings underscore the complexity of host-pathogen interactions under immunosuppressive therapy and highlight the need for larger, well-controlled studies integrating pharmacogenetics and microbial genomics.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70257"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solid Organ Transplant Recipients With Clostridioides difficile Infection Had Lower Fecal Calprotectin and Lactoferrin Levels Compared to Immunocompetent Patients: Implications for Biomarker Interpretation.","authors":"Mario Ágreda Fernández, Isabel Rodríguez-Goncer, José María Aguado, Julia Origüen, Mario Fernández-Ruiz","doi":"10.1111/tid.70288","DOIUrl":"10.1111/tid.70288","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70288"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Perianal Lesion: Host Defenses Gone Awry.","authors":"Cynthia K Wallace, Joyce Pang, Nuria Perez-Reyes, Kara Britten, Ralph Tayyar, Robert Rakita","doi":"10.1111/tid.70291","DOIUrl":"10.1111/tid.70291","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70291"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious Diseases Screening for Deceased Organ Donors: A Regional Survey From Saudi Arabia and the Gulf Cooperation Council.","authors":"Amani Hassan Yamani, Salim Sami Ghandorah, Yamama Aljishi, Ahmed A Alhammadi, Rayid Abdulqawi, Reem Mahmoud Alameer, Abdulrahman A Al-Saud, Dimitrios A Raptis, Muna Al-Maslamani, Faryal Khamis, Reem Saad Almaghrabi","doi":"10.1111/tid.70295","DOIUrl":"10.1111/tid.70295","url":null,"abstract":"<p><strong>Background: </strong>Data on deceased donor infectious diseases screening practices across the Gulf Cooperation Council (GCC) are limited, despite regional variation in transplant systems, diagnostic capacity, and cross-border organ sharing.</p><p><strong>Methods: </strong>We conducted a cross-sectional, web-based survey from August to December 2025 among infectious diseases physicians involved in solid organ transplantation across GCC countries. The survey assessed respondent characteristics, donor screening and consultation practices, perceived barriers, proposed interventions, and free-text responses. Likert-scale items were summarized using mean ± standard deviation; free-text responses were reviewed qualitatively.</p><p><strong>Results: </strong>Thirty-three infectious diseases physicians completed the survey, corresponding to an estimated response rate of 66%. Most respondents were adult infectious diseases physicians (91%). Reported practices varied: 49% reported standardized written donor-screening protocols, while infectious diseases consultation before donor acceptance occurred always in 33% and often in 30%. The highest-ranked barriers were lack of standardized regional or national guidance, insufficient infection-specific training for transplant coordinators, and absence of structured donor-derived infection reporting systems. Priority interventions included structured donor-derived infection reporting, improved rapid diagnostic capability, standardized donor screening protocols, and earlier infectious diseases involvement. Open-ended responses highlighted gaps in pending microbiology follow-up, post-procurement notification, communication, multidisciplinary donor clearance, and diagnostic workflows.</p><p><strong>Conclusion: </strong>This GCC-wide survey identifies perceived gaps in deceased donor infectious diseases risk assessment and highlights priorities for strengthening donor screening, communication, rapid diagnostics, coordinator training, and donor-derived infection reporting. Prospective evaluation is needed to determine whether these interventions improve donor utilization, transmission prevention, and transplant safety.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70295"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Prophylaxis in Pediatric Solid Organ Transplantation: A Baseline Stewardship Audit Using Routine Electronic Data.","authors":"Charles B Foster, Kaitlyn Rivard, Venkatraman A Arakoni, Blanca E Gonzalez","doi":"10.1111/tid.70266","DOIUrl":"10.1111/tid.70266","url":null,"abstract":"<p><strong>Background: </strong>Perioperative antibacterial prophylaxis in pediatric solid organ transplantation varies by center in regimen, add-on agents, and stop dates. We used institutional protocols as a unified reference standard to establish baseline stewardship measures and targets for future quality-improvement work.</p><p><strong>Methods: </strong>We retrospectively evaluated 164 pediatric transplants from 2010 to 2021. Using anesthesia timing and medication-administration data, we assessed on-time dosing, regimen selection, MRSA- and VRE-directed add-on agents, double anaerobic coverage, Gram-negative broadening during the protocol window, and discontinuation at organ-specific stop targets. We also used transplant-day anchoring and protocol-defined windows to describe whether primary-admission broad-spectrum exposure represented protocol-linked prophylaxis or later exposure. The audit measured protocol concordance and exposure patterns, not the appropriateness of deviations.</p><p><strong>Results: </strong>Prophylaxis was given on time in 95.7% of procedures. Overall, 87.2% received the recommended initial regimen, 7.3% the protocol-defined beta-lactam allergy regimen, and 4.3% another broad Gram-negative regimen. Only 61.0% stopped the main regimen by the intended cutoff; stop performance was best in kidney transplantation and poorest in intestinal and multivisceral transplantation. MRSA-directed add-ons clustered in intestinal and multivisceral procedures and often extended beyond the intended duration. A secondary descriptive analysis identified contiguous protocol-linked continuation beyond the intended window in 8.6% of primary-admission broad-spectrum days of therapy.</p><p><strong>Conclusions: </strong>Timing and initial regimen selection were strong. The main baseline process measure requiring prospective review was continuation of protocol-linked antibiotics beyond cutoffs in abdominal transplantation. This audit shows how routine electronic data can be used to create reproducible measures and organ-specific targets for future stewardship and quality-improvement studies.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70266"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive Pneumococcal Disease After Hematopoietic Cell Transplantation for Sickle Cell Disease.","authors":"Diego R Hijano, Caitlin Elgarten, Elizabeth Stenger, Katie Liu, Ann E Haight, Suhag H Parikh, Julia Gliwinski, Laurence Wechsler, Allistair Abraham, Mauricio Barreto, Timothy S Olson, Gabriela Maron, Akshay Sharma","doi":"10.1111/tid.70271","DOIUrl":"10.1111/tid.70271","url":null,"abstract":"<p><strong>Background: </strong>Children with sickle cell disease (SCD) remain at risk for invasive pneumococcal disease (IPD) because of impaired splenic function and increased susceptibility to encapsulated bacteria. Data describing IPD after allogeneic hematopoietic cell transplantation (HCT) for SCD are limited.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study of children and young adults with SCD undergoing first allogeneic HCT at two participating Sickle Cell Transplant Advocacy and Research (STAR) centers. IPD occurring within 365 days after HCT was identified through registry data, microbiologic culture review, and supplemental chart review.</p><p><strong>Results: </strong>Among 182 patients undergoing HCT, three developed IPD within the first year after transplant. All cases presented with sepsis and bacteremia; one patient also developed meningitis and died of septic shock. IPD occurred between 7 and 365 days after HCT. None of the patients had received post-transplant pneumococcal vaccination before IPD diagnosis. Serotype data were unavailable for all cases.</p><p><strong>Conclusion: </strong>In this multicenter cohort of patients with SCD undergoing allogeneic HCT, IPD was uncommon but clinically severe, including late infections occurring nearly one year after transplantation. Prospective studies evaluating immune recovery, splenic function, pneumococcal vaccination practices, and long-term infectious outcomes are needed to better define persistent susceptibility to invasive pneumococcal disease after HCT in patients with SCD.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70271"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Utility of Bronchoalveolar Lavage PCR for Nocardia and Mucorales in Lung Transplant Recipients: A Retrospective Cohort Study.","authors":"Shoaib Ahmad, Christine Pham, Curt Bay, Leena Pawar, Kendra McAnally, Michael Nailor, Kellie J Goodlet, Sofya Tokman","doi":"10.1111/tid.70249","DOIUrl":"10.1111/tid.70249","url":null,"abstract":"<p><strong>Background: </strong>Lung transplant recipients (LTRs) are susceptible to opportunistic infections, including invasive nocardiosis (IN) and invasive mucormycosis (IM). Polymerase chain reaction (PCR) testing of bronchoalveolar lavage (BAL) fluid offers rapid pathogen detection, but its clinical utility in LTRs is understudied.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective cohort study of adult LTRs who underwent BAL PCR testing for Nocardia spp. or Mucorales spp. (January 2020-December 2024); samples from both surveillance and \"for-cause\" bronchoscopies were included. The primary outcome was development of clinical infection within 6 months of PCR testing. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Patient-level analyses were performed for PCR-positive LTRs. Fisher's exact and Mann-Whitney U tests were used for calculating p-values.</p><p><strong>Results: </strong>Of 4279 Nocardia and 3588 Mucorales BAL PCR tests, 1.7% and 1.4% of samples were positive, respectively. Sensitivity, specificity, PPV, and NPV were 92.3%, 98.6%, 16.7%, and 99.98% for Nocardia and 76.2%, 99.1%, 32.0%, and 99.9% for Mucorales. Abnormal chest CT findings and for-cause bronchoscopy increased the PPV to 34.3% for Nocardia and 68.2% for Mucorales. At the patient level, both IN and IM were associated with abnormal imaging and for-cause bronchoscopy.</p><p><strong>Conclusions: </strong>BAL PCR testing for Nocardia and Mucorales demonstrates excellent specificity and NPV but low PPV. Meaningful PPV was observed primarily in patients undergoing for-cause bronchoscopy with radiographic abnormalities. PCR results can be useful adjuncts in appropriate clinical settings, but have little utility among LTRs with normal imaging undergoing surveillance testing.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70249"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Stratification for Late-Onset CMV Infection Following Prophylaxis With Letermovir in Allogeneic Stem Cell Transplant Recipients: Unraveling the Potential Role of CMV-Specific Cell-Mediated Immunity.","authors":"Alessandro Busca, Chiara Dellacasa, Roberto Passera, Luca Legato, Lorenzo Celona, Sofia Zompi, Sara Muccio, Francesca Bassi, Carolina Secreto, Luisa Giaccone, Francesca Sidoti, Cristina Costa, Silvia Corcione, Francesco Giuseppe De Rosa","doi":"10.1111/tid.70254","DOIUrl":"10.1111/tid.70254","url":null,"abstract":"<p><strong>Background: </strong>Late-onset CMV infection occurring after cessation of prophylaxis with letermovir (LTV) has been reported in a consistent number of patients receiving allogeneic hematopoietic stem cell transplantation (HSCT).</p><p><strong>Objective: </strong>The aim of this study was to investigate whether transplant characteristics and functional assays might be helpful to identify which patients might benefit from extending LTV prophylaxis to 200 days post-HSCT.</p><p><strong>Study design: </strong>A total of 95 patients with hematological malignancies who received prophylaxis with LTV until Day +100 were included in the study. Analysis of CMV-specific cell-mediated immunity (CMV-CMI) was performed with QuantiFERON-CMV (QTF-CMV) assay at the end of LTV administration.</p><p><strong>Results: </strong>Overall, 23 patients experienced clinically significant CMV infection (csCMVi) after the end of prophylaxis with LTV, leading to a 20% cumulative incidence (CI) of csCMVi at 180 days. Seven of the 46 patients (15%) with positive QTF-CMV at Day +100 had late-onset csCMVi, compared to 15 of the 43 patients (35%) with negative QTF-CMV (p = 0.048). The CI of late-onset csCMVi was 41.4% in patients with GVHD and negative QTF-CMV as compared to 0% in patients with no GVHD and a positive QTF-CMV (p = 0.002). In multivariate analysis, D-/R+ CMV serology (OR 3.69:1.31-10.42, p = 0.014) and GVHD (OR 3.42: 1.00-11.66, p = 0.050) were factors independently associated with the probability of late-onset csCMVi.</p><p><strong>Conclusion: </strong>Our findings suggest that D-/R+ CMV serology and the presence of GVHD, combined with CMV-QTF, may be considered as a useful tool to predict which patients receiving LTV might benefit from an extension of prophylaxis up to 200 days after HSCT.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70254"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbial Contamination in Deceased Musculoskeletal Tissue Donors: A Large-Scale US Analysis of Infection Risk.","authors":"Anthony Montedonico, Kimberly Elliott, Lee Brandenburg, Sara O Dionne","doi":"10.1111/tid.70234","DOIUrl":"10.1111/tid.70234","url":null,"abstract":"<p><strong>Background: </strong>Microbial contamination of musculoskeletal tissues recovered from deceased donors poses a risk for donor-derived infections and may lead to tissue exclusion under regulatory standards. Despite stringent aseptic protocols, recovery and processing contamination remains a critical challenge. This study presents a large-scale analysis of microbial prevalence and distribution in deceased tissue donors in the United States.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 1 186 392 musculoskeletal tissue recovery swabs collected from 69 920 deceased donors between 2019 and 2024. Growth-positive cultures underwent organism identification using MALDI-TOF mass spectrometry and biochemical methods. Microbial findings were stratified by anatomical recovery zone, and organisms considered potentially disqualifying for transplantation were assessed according to American Association of Tissue Banks (AATB) standards.</p><p><strong>Results: </strong>Microbial growth was observed in 12.4% of swabs, with 64.8% of donors having at least one growth-positive sample. Among positive swabs, 92.4% yielded bacteria, 5.0% fungi, and 2.6% yielded both. Organisms considered potentially disqualifying were identified in 5.0% of donors, most commonly Clostridium species and Streptococcus pyogenes. The prevalence of virulent organisms varied by anatomical recovery zone, with the highest rates observed in lower extremity and pelvic sites and the lowest in thoracic and vertebral tissues.</p><p><strong>Conclusion: </strong>In this large national cohort, potentially virulent microorganisms were identified in a clinically meaningful proportion of deceased tissue donors, with substantial anatomical variability in contamination risk. These findings reinforce the importance of stringent microbiological screening to reduce the risk of recipient infection while supporting safe and effective tissue transplantation.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70234"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ARC in Critical Ill OLT Recipients: True Prevalence, Risk Factors, and Impact on Early Aggressive PK/PD Target Non-Attainment of CI Beta-Lactam Therapy for Posttransplant Gram-Negative Infections.","authors":"Milo Gatti, Riccardo De Paola, Matteo Rinaldi, Cristiana Laici, Antonio Siniscalchi, Pierluigi Viale, Federico Pea","doi":"10.1111/tid.70237","DOIUrl":"10.1111/tid.70237","url":null,"abstract":"<p><strong>Background: </strong>To assess the true prevalence and the risk factors of augmented renal clearance (ARC) in critical orthotopic liver transplant (OLT) recipients and its impact on early aggressive pharmacokinetic/pharmacodynamic (PK/PD) target non-attainment of continuous infusion (CI) beta-lactams.</p><p><strong>Methods: </strong>OLT recipients without renal dysfunction and undergoing one or more measured creatinine clearance (mCLCr) assessments in the first 30 days posttransplant were retrospectively included. Reliability of three different eGFR formulas (Cockcroft-Gault, 2021, CKD-EPI, and MDRD) in estimating mCLCr was tested. Univariate analyses compared the clinical features of ARC versus non-ARC patients and the severity of the clinical conditions during ARC versus non-ARC episodes in the whole cohort. In patients receiving CI beta-lactam therapy, risk factors for early aggressive PK/PD target non-attainment were investigated.</p><p><strong>Results: </strong>Among 450 critical OLT recipients, 112 were included. The true prevalence of ARC was 23.2%. ARC versus non-ARC patients were younger (p = 0.003), had lower MELD score (p = 0.001), received lower number of intraoperative blood transfusions (p = 0.007), and had a lower need for venovenous bypass technique (p = 0.024). ARC episodes occurred more frequently in patients having lower SOFA score (p = 0.005) and lower median serum creatinine levels (p < 0.001). None of the eGFR formulas properly estimated mCLCr. In the subset of 50 OLT recipients receiving 60 CI beta-lactam treatment courses, ARC was the only factor associated with early aggressive PK/PD target non-attainment (p = 0.018).</p><p><strong>Conclusions: </strong>ARC is a quite prevalent condition among critical OLT recipients, which may hinder early aggressive PK/PD target attainment when using standard beta-lactams dosing regimens, regardless of delivery by CI.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70237"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}