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Related Experiment Videos

Posttransplant microbiological surveillance.

D R Snydman1

  • 1Department of Medicine, New England Medical Center, and Tufts University School of Medicine, Boston, MA 02111, USA. dsnydman@lifespan.org

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|June 5, 2001
PubMed
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Posttransplant microbiological surveillance is recommended for high-risk transplant recipients, focusing on specific infections like cytomegalovirus and Epstein-Barr virus. Routine bacterial and fungal surveillance are generally not needed, with exceptions for high-risk groups.

Area of Science:

  • Transplant medicine
  • Infectious diseases
  • Microbiology

Background:

  • Posttransplant infections pose a significant risk to recipients.
  • Effective surveillance strategies are crucial for timely diagnosis and management.
  • Tailoring surveillance based on individual risk and specific pathogens is essential.

Purpose of the Study:

  • To define the optimal use of posttransplant microbiological surveillance.
  • To identify specific infections and patient groups that benefit most from surveillance.
  • To differentiate between necessary and unnecessary routine surveillance practices.

Main Methods:

  • Review of current literature and clinical guidelines on posttransplant surveillance.
  • Analysis of diagnostic test performance, including sensitivity, specificity, and predictive values.

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  • Evaluation of successful surveillance programs for viral, fungal, and bacterial infections.

    • Main Results:

    • Microbiological surveillance is most valuable when infection likelihood is high and tests offer high predictive values.
    • Successful surveillance examples include molecular detection and viral load monitoring for cytomegalovirus (CMV) and Epstein-Barr virus (EBV), as well as hepatitis B and C.
    • Routine fungal and bacterial surveillance are generally not indicated, except for specific high-risk scenarios like Candida colonization or vancomycin-resistant enterococci (VRE) detection.

    Conclusions:

    • Posttransplant microbiological surveillance should be judiciously applied based on risk stratification and predictive test performance.
    • Targeted viral surveillance (CMV, EBV, Hepatitis B/C) is highly beneficial.
    • Routine broad-spectrum fungal and bacterial surveillance is typically unnecessary, with organ-specific considerations guiding recommendations.