Differences by transplant type in stool multiplex PCR testing for acute diarrhea in post-solid organ transplantation

Area of Science:

• Infectious Diseases
• Transplantation Medicine
• Clinical Diagnostics

Background:

• Diarrhea is a frequent complication in solid organ transplant (SOT) recipients, often requiring diagnostic evaluation.
• Multiplex gastrointestinal PCR panels (GI panels) are increasingly utilized for diagnosing acute diarrhea in SOT patients.
• Understanding variations in diagnostic yield based on transplant type is crucial for effective patient management.

Purpose of the Study:

• To investigate the differences in GI panel testing results for acute diarrhea among various solid organ transplant types.
• To identify factors associated with positive GI panel results in SOT recipients.

Main Methods:

• A retrospective, dual-center cross-sectional study was conducted.
• Adult SOT recipients experiencing acute diarrhea and undergoing GI panel testing were included.
• Data on demographics, transplant characteristics, testing context, and GI panel results were collected and analyzed, stratifying by transplant type.

Main Results:

• Out of 300 SOT recipients, 118 (39.3%) had a positive GI panel.
• Renal transplant recipients showed a higher frequency of positive GI panels and lower hospitalization rates compared to other groups.
• Multivariate analysis revealed renal transplantation, older transplant age, and outpatient testing were independently associated with positive GI panel results.

Conclusions:

• GI panel results for acute diarrhea in SOT recipients differ significantly based on transplant type, transplant age, and testing location.
• These diagnostic findings can influence subsequent antimicrobial therapy decisions in SOT patients.