TY - JOUR
T1 - Antimicrobial Prophylaxis in Solid Organ and Hematopoietic Stem Cell Transplantation
T2 - A Survey Among Member Centers of the European Reference Network TransplantChild
AU - Donà, Daniele
AU - Liberati, Cecilia
AU - the ERN-TransplantChild
AU - Aidala, Enrico
AU - Bekassy, Zivile
AU - Bjerre, Anna
AU - Bordon, Victoria
AU - Sanchez, David Bueno
AU - Bouts, Antonia H.M.
AU - Bravo-Gallego, Luz Yadira
AU - Casotti, Valeria
AU - Catalano, Silvia
AU - Costa-Reis, Patricia
AU - Cucinotta, Ugo
AU - Debray, Dominique
AU - De Jong, Huib
AU - De la Cerda-Ojeda, Francisco
AU - De la Serna, Olga
AU - Ferreira, Sandra
AU - Fischler, Björn
AU - Guereta, Luis García
AU - Gil, Nuria
AU - Vincent, Marta González
AU - Gran-Ipiña, Ferran
AU - Grenda, Ryszard
AU - Grima, Daniela
AU - Herden, Uta
AU - Hierro, Maria Loreto
AU - Huerta, Jorge
AU - Jahnukainen, Timo
AU - Jankauskiene, Augustina
AU - Kaliciński, Piotr
AU - Kötz, Karsten
AU - Lopes, Maria Francelina
AU - Gonzales, Mercedes Lopez
AU - Madrid, Álvaro
AU - Mercadal-Hally, Maria
AU - Marsal, Julia
AU - Marzollo, Antonio
AU - Mellgren, Karin
AU - Mendoza-Palomar, Natalia
AU - Mutschler, Frauke
AU - Odermarsky, Michal
AU - De Mendoza, José María Pérez Hurtado
AU - Peruzzi, Licia
AU - Pietrobattista, Andra
AU - Pinon, Michele
AU - Prytula, Agnieszka
AU - Ramos, Esther Boluda
AU - Ranucci, Giusy
AU - Rascon, Jelena
AU - Benetti, Elisa
N1 - Publisher Copyright:
© 2026 Wiley Periodicals LLC.
PY - 2026/7
Y1 - 2026/7
N2 - Background: Antimicrobial management in pediatric transplantation lacks standardized international guidelines, and current practices across European transplant centers remain poorly described. This study aimed to evaluate microbiological screening and peri-transplant antimicrobial strategies among centers participating in the European Reference Network on Transplantation in Children (ERN TransplantChild), including both solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT) programs.Methods: Between December 2022 and February 2023, healthcare professionals within the network completed a structured survey addressing microbiological screening practices and peri-transplant antimicrobial strategies in pediatric transplant recipients. Results: Of 127 transplant programs invited, 76 (59.8%) responded, including 62 SOT and 14 HSCT programs from 36 centers across 16 European countries. Pre-transplant screening strategies, microbiological methods, and decolonization practices varied substantially between centers. Reported prevalence of methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase–producing organisms was below 10% in most programs. In SOT, perioperative prophylaxis varied according to transplanted organ type. Cephalosporins were most commonly used in kidney and heart transplantation, whereas broader-spectrum regimens, including piperacillin–tazobactam and vancomycin, were more frequently adopted in liver, intestinal, and lung transplantation. Postoperative prophylaxis was continued beyond 24 h in most SOT programs. Antifungal prophylaxis was more commonly adopted in liver, intestinal, and lung transplant recipients. In HSCT, antibacterial peri-transplant use was not routinely prescribed in a substantial proportion of programs, particularly in autologous transplantation, whereas antifungals were widely used in allogeneic HSCT. Conclusions: Marked heterogeneity in microbiological screening and peri-transplant antimicrobial strategies across European pediatric transplant centers underscores the need for transplant-specific, evidence-based guidelines distinguishing between SOT and HSCT settings. These findings provide a foundation for the development of shared clinical pathways and harmonized recommendations.
AB - Background: Antimicrobial management in pediatric transplantation lacks standardized international guidelines, and current practices across European transplant centers remain poorly described. This study aimed to evaluate microbiological screening and peri-transplant antimicrobial strategies among centers participating in the European Reference Network on Transplantation in Children (ERN TransplantChild), including both solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT) programs.Methods: Between December 2022 and February 2023, healthcare professionals within the network completed a structured survey addressing microbiological screening practices and peri-transplant antimicrobial strategies in pediatric transplant recipients. Results: Of 127 transplant programs invited, 76 (59.8%) responded, including 62 SOT and 14 HSCT programs from 36 centers across 16 European countries. Pre-transplant screening strategies, microbiological methods, and decolonization practices varied substantially between centers. Reported prevalence of methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase–producing organisms was below 10% in most programs. In SOT, perioperative prophylaxis varied according to transplanted organ type. Cephalosporins were most commonly used in kidney and heart transplantation, whereas broader-spectrum regimens, including piperacillin–tazobactam and vancomycin, were more frequently adopted in liver, intestinal, and lung transplantation. Postoperative prophylaxis was continued beyond 24 h in most SOT programs. Antifungal prophylaxis was more commonly adopted in liver, intestinal, and lung transplant recipients. In HSCT, antibacterial peri-transplant use was not routinely prescribed in a substantial proportion of programs, particularly in autologous transplantation, whereas antifungals were widely used in allogeneic HSCT. Conclusions: Marked heterogeneity in microbiological screening and peri-transplant antimicrobial strategies across European pediatric transplant centers underscores the need for transplant-specific, evidence-based guidelines distinguishing between SOT and HSCT settings. These findings provide a foundation for the development of shared clinical pathways and harmonized recommendations.
UR - https://www.scopus.com/pages/publications/105043510850
U2 - 10.1111/petr.70379
DO - 10.1111/petr.70379
M3 - Article
AN - SCOPUS:105043510850
SN - 1397-3142
VL - 30
JO - Pediatric Transplantation
JF - Pediatric Transplantation
IS - 7
M1 - e70379
ER -