Infections in Critically Ill Solid Organ Transplant Recipients

In recent years, advances in surgical techniques, immunosuppressant drugs, diagnostic tests and preventive strategies against a large number of pathogens have achieved considerably lower infection rates among recipients of a solid organ transplant. Certain opportunistic infections such as cytomegalovirus (CMV) and Pneumocystis jiroveci have undergone an important reversal in the past decade. Nevertheless, the appearance of new pathogens and the escalation of antibiotic resistance have altered the spectrum of the microorganisms involved and, consequently, infection management in the transplant patient. Nosocomial infection, in particular hospital-acquired bacterial infection, is presently the main source of infection following transplantation. Up to 53% of infections in a group of heart transplant recipients were considered to be hospital-acquired and 63% of them were bacterial [1]. In liver transplant recipients, 82% of all febrile episodes in a 2-year period were described as nosocomial in origin, with 62% of bacterial etiology [2].