Open AccessEmerging Microbiology Diagnostics for Transplant Infections: On the Cusp of a Paradigm Shift
Author(s) -
Marwan M. Azar,
David C. Gaston,
Camille Nelson Kotton,
Maricar Malinis
Publication year - 2020
Publication title -
transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/tp.0000000000003123
Subject(s) - clinical microbiology , molecular diagnostics , metagenomics , medicine , medical microbiology , transplantation , intensive care medicine , computational biology , biology , immunology , microbiology and biotechnology , bioinformatics , biochemistry , gene
In light of the heightened risk for infection associated with solid organ and hematopoietic stem cell transplantation, rapid and accurate microbiology diagnostics are essential to the practice of transplant clinicians, including infectious diseases specialists. In the last decade, diagnostic microbiology has seen a shift toward culture-independent techniques including single-target and multiplexed molecular testing, mass-spectrometry, and magnetic resonance-based methods which have together greatly expanded the array of pathogens identified, increased processing speed and throughput, allowed for detection of resistance determinants, and ultimately improved the outcomes of infected transplant recipients. More recently, a newer generation of diagnostics with immense potential has emerged, including multiplexed molecular panels directly applicable to blood and blood culture specimens, next-generation metagenomics, and gas chromatography mass spectrometry. Though these methods have some recognized drawbacks, many have already demonstrated improved sensitivity and a positive impact on clinical outcomes in transplant and immunocompromised patients.