REVIEW article
Front. Microbiol.
Sec. Antimicrobials, Resistance and Chemotherapy
This article is part of the Research TopicMultidrug Resistant Gram-negative Bacteria in Fragile HostsView all 12 articles
Multidrug-resistant Gram-negative bacteria in lung transplantation: a narrative review of infectious complications and current management
Provisionally accepted
MARGHERITA SAMBO1*
GABRIELE GIULIANO1
David Bennett2
Luca Luzzi1,2
Federico Franchi1,2
Mario Tumbarello1,2
Francesca Montagnani1,2- 1Universita degli Studi di Siena, Siena, Italy
- 2Azienda Ospedaliero-Universitaria Senese, Siena, Italy
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Multidrug-resistant Gram-negative bacterial (MDR-GNB) infections represent a major challenge in lung transplantation (LuTx), due to their possible association with poor clinical outcomes and the limited availability of effective antimicrobial agents. Nevertheless, MDR-GNB colonization or infection is no longer considered an absolute contraindication to transplantation. Recent recommendations issued by leading societies in clinical microbiology and infectious diseases, national expert groups, and transplant medicine professionals provide updated recommendations on antimicrobial strategies, encompassing both established and newly approved agents. Following an overview of the epidemiology of infections in LuTx recipients, with a focus on the specific impact of MDR-GNB, this review aims to explore current evidence on diagnostic approaches, prophylactic measures, and therapeutic management. Remaining knowledge gaps in this area are also highlighted, emphasizing the need for further research to optimize prevention and treatment strategies in this high-risk population.
Keywords: lung transplantation1, multidrug resistant gram-negative bacteria2, difficult to treatinfections3, immunocompromised host4, antibiotic prophylaxis5
Received: 28 Jul 2025; Accepted: 25 Nov 2025.
Copyright: © 2025 SAMBO, GIULIANO, Bennett, Luzzi, Franchi, Tumbarello and Montagnani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: MARGHERITA SAMBO
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