Introduction:
Kidney transplant recipients are prone to post-transplant infections, compromising graft function and survival. In India, respiratory infections (RI) and gastrointestinal infections (GI) are primary causes of morbidity and mortality. Diagnostic challenges lead to empirical antibiotic therapy, contributing to antimicrobial resistance. Advanced molecular diagnostics like BioFire FilmArray are needed to accurately identify pathogens and guide targeted therapy, enhancing patient outcomes and antimicrobial stewardship.
Methods:
We conducted a retrospective cohort study (2022-2024) of 50 renal transplant recipients, divided into two groups: 30 with RI and 20 with GI. The study analyzed demographic data, transplant modalities, immunosuppressive regimens, clinical presentations, diagnostic methods, therapeutic interventions, and patient outcomes. This study aimed to elucidate factors associated with RI and GI in post-renal transplant patients, informing evidence-based management utilizing BioFire FilmArray GI and Pneumonia Panels which employ multiplex Polymerase Chain reaction (PCR) technology for rapid diagnosis, providing timely (≈1 hour) results, facilitating prompt targeted treatment decisions.
Results:
A retrospective cohort analysis of 20 patients with GI infections revealed a significantly higher diagnostic yield with the BioFire GI panel (80%, p < 0.01) compared to conventional stool examinations (20%). Polymicrobial infections were prevalent (56.3%), with a predominance of bacterial (75%), followed by parasitic (43.8%) and viral (25%) pathogens. Immunosuppressive therapy escalation was identified as a precipitating factor in 37.5% of patients.
A separate analysis of 30 patients presenting with RI demonstrated a higher positivity rate with the BioFire Pneumonia panel (83.3%) versus conventional culture methods (23.3%). Mixed infections were common (68%), with a predominance of bacterial (44%), followed by viral (36%) and fungal (20%) pathogens.
Conclusions:
The multiplex PCR BioFire FilmArray Pneumonia and GI panel transforms diagnostic technology, enabling rapid and accurate identification of multiple pathogens in post-renal transplant recipients. This cutting-edge assay facilitates prompt, targeted interventions, reducing turnaround time, avoiding antibiotic misuse, and minimizing invasive procedures, making its adoption a potential new standard of care.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.