Infection Prevention and Surveillance in the Care of Australasian Solid-Organ Transplant Recipients

Infection is a significant cause of morbidity and mortality among solid-organ transplant (SOT) recipients. Australasia currently has no standardized system for the surveillance of infection across organ-transplant groups nor SOT-specific infection prevention and control (IPC) guidelines. This sub-cohort analysis of the INTERACT study sought to understand existing IPC and infection monitoring practices in Australasian centers providing transplant care to guide consensus recommendations.

A cross-sectional survey was administered to infectious disease (ID), microbiology, and IPC specialists involved in the care of the high-risk immunocompromised host within Australasian healthcare facilities (HCFs).

A total of 97 healthcare workers caring for SOT patients responded, predominantly employed by public HCFs. A total of 76.3% were practicing in transplant centers (primarily renal), with responses gained from all Australasian transplant jurisdictions. Although on-site IPC programs were customary (present in 96.9%), few had dedicated transplant-ID services (38.1%). Surveillance for healthcare-associated infections was reported by the majority (75.3%), with monitoring for opportunistic infections less frequent (23.7%). While 50.5% reported a staff mask-wearing mandate, and 22.7% a gown/glove policy on transplant wards, the timing of routine personal protective use post-transplantation was heterogeneous. Screening practices for multidrug-resistant organisms varied, with routine approaches more prevalent within facilities performing transplant surgery (38.1%-100.0% vs. 39.1%-46.4%). Just over half (58.8%) of respondents provided counselling to SOT recipients for safe-living post-discharge.

This is the first analysis of IPC/surveillance practice in the care of the Australasian SOT population, revealing practice variability and emphasizing the need for standardization to optimize transplant outcomes and reduce infection risk.