metricas
covid
Buscar en
Enfermedades Infecciosas y Microbiología Clínica
Toda la web
Inicio Enfermedades Infecciosas y Microbiología Clínica The role of the clinical microbiology laboratory in solid organ transplantation ...
Información de la revista
Vol. 30. Núm. S2.
Infections in solid organ transplantation
Páginas 2-9 (marzo 2012)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 30. Núm. S2.
Infections in solid organ transplantation
Páginas 2-9 (marzo 2012)
Acceso a texto completo
The role of the clinical microbiology laboratory in solid organ transplantation programs
Papel del laboratorio de microbiología clínica en los programas de trasplante de órgano sólido
Visitas
3557
José L. Péreza,
Autor para correspondencia
josel.perez@ssib.es

Corresponding author.
, Josefina Ayatsb, María de Oñac, Tomàs Pumarolad
a Service of Microbiology, Hospital Universitario Son Espases, Palma de Mallorca, Spain
b Service of Microbiology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
c Service of Microbiology, Hospital Central de Asturias, Oviedo, Asturias, Spain
d Service of Microbiology, Hospital Clínic, Barcelona, Spain
Este artículo ha recibido
Información del artículo
Abstract

Infections remain a major complication of solid organ transplantation. For this reason, the clinical microbiology laboratory plays a key role in the success of transplant programs, which must have the support of a qualified laboratory, both technically and professionally. Transplant programs strongly condition the structure and functionality of microbiology laboratories, but at the same time, benefit greatly from the knowledge generated from these programs. The laboratory must make a special effort to implement rapid methods that can respond to the broad spectrum of potential pathogens in solid organ transplant patients. The integration of microbiologists in multidisciplinary teams is highly recommended, as only then can they obtain the highest quality and efficiency in the diagnostic process. This article provides an updated review of the techniques to be used once transplantation has occurred. The role of the microbiologist is also crucial in the pretransplant period, as good microbiological candidate evaluation at this time strongly conditions the success of the transplantation program.

Keywords:
Laboratory diagnosis
Role of the microbiology laboratory
Solid organ transplantation
Transplantation microbiology
Resumen

Las infecciones siguen siendo una importante complicación del trasplante de órgano sólido. Por esta razón, el laboratorio de microbiología clínica desempeña un papel clave en el éxito de los programas de trasplante. Estos programas deben tener el apoyo de un laboratorio cualificado, tanto técnica como profesionalmente. Los programas de trasplante condicionan fuertemente la estructura y funcionalidad de los laboratorios de microbiología, pero al mismo tiempo se benefician enormemente del conocimiento generado alrededor de dichos programas. El laboratorio debe hacer un esfuerzo especial en la puesta en marcha de métodos rápidos que den respuesta al amplio espectro de potenciales patógenos en los pacientes de trasplantes sólidos. La integración del microbiólogo en los equipos multidisciplinares es muy recomendable y sólo así se puede obtener la calidad y mayor eficiencia del proceso diagnóstico. En este artículo se lleva a cabo una puesta al día de las técnicas utilizables una vez que se ha realizado el trasplante. No obstante, el papel del microbiólogo es también crucial en el período previo al trasplante, ya que una buena evaluación microbiológica del candidato en este momento condiciona fuertemente el éxito del programa de trasplante.

Palabras clave:
Diagnóstico de laboratorio
Microbiología del trasplante
Papel del laboratorio de microbiología
Trasplante de órgano sólido
El Texto completo está disponible en PDF
References
[1.]
M.T. LaRocco, S.J. Burgert.
Infection in the bone marrow transplant recipient and role of the microbiology laboratory in clinical transplantation.
Clin Microbiol Rev, 10 (1997), pp. 277-297
[2.]
J.A. Fishman.
Transplantation microbiology: an evolving pillar of transplant care.
Am J Transplant, 9 (2009), pp. 249-250
[3.]
J.L. Pérez Sáenz, J. Ayats Ardite, J. Fortún Abete, M. de Oña Navarro, T. Pumarola Suñé.
Microbiología del trasplante.
Procedimientos en microbiología clínica, n.° 5, 2. ª,
[4.]
C. Cervera, L. Linares, G. Bou, A. Moreno.
Multidrug-resistant bacterial infection in solid organ transplant recipients.
Enferm Infecc Microbiol Clin, 30 (2012), pp. 40-48
[5.]
P. Muñoz, C. Rodríguez, E. Bouza.
Mycobacterium tuberculosis infection in recipients of solid organ transplants.
Clin Infect Dis, 40 (2005), pp. 581-587
[6.]
J.M. Aguado, J. Torre-Cisneros, J. Fortún, N. Benito, Y. Meije, A. Doblas, P. Muñoz.
Tuberculosis in solid-organ transplant recipients: consensus statement of the Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology.
Clin Infect Dis, 48 (2009), pp. 1276-1284
[7.]
A.N. Zeka, S. Tasbakan, C. Cavusoglu.
Evaluation of the GeneXpert MTB/RIF Assay for the rapid diagnosis of tuberculosis and detection of RIF-resistance in pulmonary and extrapulmonary specimens.
J Clin Microbiol, 49 (2011), pp. 4138-4141
[8.]
V.G. Loo, L. Poirier, M.A. Miller, M. Oughton, M.D. Libman, S. Michaud, et al.
A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality.
N Eng J Med, 353 (2005), pp. 2442-2449
[9.]
G.P. Pappas, B.D. Alexander, D.R. Andes, S. Hadley, C.A. Kauffman, A. Freifeld, et al.
Invasive fungal infections among organ transplant recipients: resuslts of the Transplant-associated Infections Surveillance Network (TRANSNET).
Clin Infect Dis, 50 (2010), pp. 1101-1111
[10.]
M. Cuenca-Estrella, M. Bassetti, C. Lass-Flörl, Z. Rácil, M. Richardson, T.R. Rogers.
Detection and investigation of invasive mould disease.
J Antimicrob Chemother, 66 (2001), pp. i15-i24
[11.]
O. Marchetti, F. Lamoth, M. Mikulska, C. Viscoli, P. Verweij, S. Bretagne.
ECIL recommendations for the use of biological markers for the diagnosis of invasive fungal diseases in leukemic patients and hematopoietic SCT recipients.
Bone Marrow Transplant, (2011),
[12.]
S. Koo, J.M. Bryar, J.H. Page, L.R. Baden, FMl. Marty.
Diagnostic performance of the (1,3)-ß-D-glucan assay for invasive fungal disease.
Clin Infect Dis, 49 (2009), pp. 1650-1659
[13.]
T. Obayashi, K. Negishi, T. Suzuki, N. Funata.
Reappraisal of the serum (1,3)-ß-Dglucan assay for the diagnosis of invasive fungal infections- a study based on autopsy cases from 6 years.
Clin Infect Dis, 46 (2008), pp. 1864-1870
[14.]
B. De Pauw, T.J. Walsh, J.P. Donnelly, D.A. Stevens, J.E. Edwards, T. Calandra, et al.
Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group.
Clin Infect Dis, 46 (2008), pp. 1813-1821
[15.]
A. Sulahian, M. Tabouret, P. Ribaud, J. Sarfati, E. Gluckman, J.P. Latgé, et al.
Comparison of an enzyme immunoassay and latex agglutination test for detection of galactomannan in the diagnosis of invasive aspergillosis.
Eur J Clin Microbiol Infect Dis, 15 (1996), pp. 139-145
[16.]
J. Maertens, V. Maertens, K. Theunissen, W. Meersseman, P. Meersseman, S. Meers, et al.
Bronchoalveolar lavage fluid galactomannan for the diagnosis of invasive pulmonary aspergillosis in patients with hematologic diseases.
Clin Infect Dis, 49 (2009), pp. 1688-1693
[17.]
S. Husain, D.L. Paterson, S.M. Studer, M. Crespo, J. Pilewski, M. Durkin, et al.
Aspergillus galactomannan antigen in the bronchoalveolar lavage fluid for the diagnosis of invasive aspergillosis in lung transplant recipients.
Transplantation, 83 (2007), pp. 1330-1336
[18.]
P.L. White, S. Bretagne, L. Klingspor, W.J. Melchers, E. McCulloch, B. Schulz, et al.
Aspergillus PCR: one step closer to standarization.
J Clin Microbiol, 48 (2010), pp. 1231-1240
[19.]
C. Mengoli, M. Cruciani, R.A. Barnes, J. Loeffler, J.P. Donnelly.
Use of PCR for diagnosis of invasive aspergillosis: systematic review and meta-analysis.
Lancet Infec Dis, 9 (2009), pp. 89-96
[20.]
Clinical Laboratory Standards Institute. Reference method for broth dilution antifungal susceptibility testing of yeast. Approved standard. 3rd ed. CLSI document M27-A3. Clinical Laboratory Standards Institute. 2008. Wayne, Pennsylvania, USA.
[21.]
Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST).
EUCAST Definitive Document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts.
Clin Microbiol Infect, 14 (2008), pp. 398-405
[22.]
R. Osawa, B.D. Alexander, O. Lortholary, F. Dromer, G.N. Forrest, G.M. Lyon, et al.
Identifying predictors of central nervous system disease in solid organ transplant recipients with cryptococcosis.
Transplantation, 89 (2010), pp. 69-74
[23.]
E. Azoulay, A. Bergeron, S. Chevret, N. Bele, B. Schlemmer, J. Menotti.
Polymerase chain reaction for diagnosing pneumocystis pneumonia in non-HIV immunocompromised patients with pulmonary infiltrates.
Chest, 135 (2009), pp. 655-661
[24.]
P.M. Hauser, J. Bille, C. Lass-Flörl, C. Geltner, M. Feldmesser, M. Levi, et al.
Multicenter, prospective clinical evaluation of respiratory samples from subjects at risk for Pneumocystis jirovecii infection by use of a commercial real-time PCR assay.
J Clin Microbiol, 49 (2011), pp. 1872-1878
[25.]
F.M. Marty, S. Koo, J. Bryar, L.R. Baden.
(1->3)beta-D-glucan assay positivity in patients with Pneumocystis (carinii) jiroveci pneumonia.
Ann Intern Med, 147 (2007), pp. 70-72
[26.]
O. Len, J. Ayats.
Infecciones por protozoos.
Infecciones en pacientes trasplantados, 3. ª, pp. 323-338
[27.]
S. Antinori, A. Cascio, C. Parravicini, R. Bianchi, M. Corbellino.
Leishmaniasis among organ transplant patients.
Lancet Infect Dis, 8 (2008), pp. 191-198
[28.]
S. Gatti, M. Gramegna, C. Klersy, S. Madama, A. Bruno, R. Maserati, et al.
Diagnosis of visceral leishmaniasis: the sensitivities and specificities of traditional methods and a nested PCR assay.
Ann Trop Med Parasitol, 7 (2004), pp. 667-676
[29.]
C. Franco-Paredes, J.T. Jacob, A. Hidron, A.J. Rodríguez-Morales, D. Kuhar, A.M. Caliendo.
Transplantation and tropical infectious diseases.
Int J Infect Dis, 14 (2010), pp. e189-e196
[30.]
A.C. Roxby, G.S. Gottlieb, A.P. Limaye.
Strongyloidiasis in transplant patients.
Clin Infec Dis, 49 (2009), pp. 1411-1423
[31.]
J.M. Aguado, D. Navarro, R. San Juan, J.J. Castón.
Cytomegalovirus infection in solid organ transplantation.
Enferm Infecc Microbiol Clin, 30 (2012), pp. 57-62
[32.]
J. Carratalà, M. Montejo, P. Pérez Romero.
Infections caused by herpes viruses other than cytomegalovirus in solid organ transplant recipients.
Enferm Infecc Microbiol Clin, 30 (2012), pp. 63-69
[33.]
I. Garrigue, S. Boucher, L. Couzi, A. Caumont, C. Dromer, M. Neau-Cransac, et al.
Whole blood real-time quantitative PCR for cytomegalovirus infection follow-up in transplant recipients.
J Clin Virol, 36 (2006), pp. 72-75
[34.]
R.R. Razonable, R.A. Brown, J. Wilson, C. Groettum, W. Kremers, M. Espy, et al.
The clinical use of various blood compartments for cytomegalovirus (CMV) DNA quantitation in transplant recipients with CMV disease.
Transplantation, 73 (2002), pp. 968-973
[35.]
G. Gerna, D. Lilleri, M. Furione, F. Baldanti.
Management of human cytomegalovirus infection in transplantation: validation of virologic cut-offs for preemptive therapy and immunological cut-offs for protection.
New Microbiol, 34 (2011), pp. 229-254
[36.]
E.D. Greanya, N. Partovi, E.M. Yoshida, R.J. Shapiro, R.D. Levy, C.H. Sherlock, et al.
The role of the cytomegalovirus antigenemia assay in the detection and prevention of cytomegalovirus syndrome and disease in solid organ transplant recipients: A review of the British Columbia experience.
Can J Infect Dis Med Microbiol, 16 (2005), pp. 335-341
[37.]
H. Omar, H. Hägglund, A. Gustafsson-Jernberg, K. LeBlanc, J. Mattsson, M. Remberger, et al.
Targeted monitoring of patients at high risk of post-transplant lymphoproliferative disease by quantitative Epstein-Barr virus polymerase chain reaction.
Transpl Infect Dis, 11 (2009), pp. 393-399
[38.]
A. Bakran, I.J. Hart.
Human herpesvirus 6 infection after solid organ transplantation.
Transplantation, 88 (2009), pp. 757-758
[39.]
E. Csoma, B. Mészáros, T. Gáll, L. Asztalos, J. Kónya, L. Gergely.
Dominance of variant A in human herpesvirus 6 viraemia after renal transplantatio.
[40.]
R.R. Razonable, D.M. Zerr.
HHV-6, HHV-7 and HHV-8 in solid organ transplant recipients.
Am J Transplant, 9 (2009), pp. S97-S103
[41.]
M. Camps Serra, C. Cervera, T. Pumarola, A. Moreno, R. Perelló, A. Torres, et al.
Virological diagnosis in community-acquired pneumonia in immunocompromised patients.
Eur Respir J, 31 (2008), pp. 618-624
[42.]
N. Johansson, M. Kalin, A. Tiveljung-Lindell, C.G. Giske, J. Hedlund.
Etiology of community-acquired pneumonia: increased microbiological yield with new diagnostic methods.
Clin Infect Dis, 50 (2010), pp. 202-209
[43.]
D.R. Murdoch, K.L. O’Brien, J.A. Scott, R.A. Karron, N. Bhat, A.J. Driscoll, et al.
Breathing new life into pneumonia diagnostics.
J Clin Microbiol, 47 (2009), pp. 3405-3408
[44.]
K. Loens, L. Van Heirstraeten, S. Malhotra-Kumar, H. Goossens, M. Ieven.
Optimal sampling sites and methods for detection of pathogens possibly causing community-acquired lower respiratory tract infections.
J Clin Microbiol, 47 (2009), pp. 21-31
[45.]
T. Jartti, L. Jartti, V. Peltola, M. Waris, O. Ruuskanen.
Identification of respiratory viruses in asymptomatic subjects: asymptomatic respiratory viral infections.
Pediatr Infect Dis J, 27 (2008), pp. 1103-1107
[46.]
M.A. Marcos, S. Ramón, A. Antón, E. Martinez, A. Vilella, V. Olivé, et al.
Clinical relevance of mixed respiratory viral infections in adults with influenza A H1N1.
Eur Respir J, 38 (2011), pp. 739-742
[47.]
G. Paranhos-Baccalà, F. Komurian-Pradel, N. Richard, G. Vernet, B. Lina, D. Floret.
Mixed respiratory virus infections.
J Clin Virol, 43 (2008), pp. 407-410
[48.]
F.G. Hayden.
Rhinovirus and the lower respiratory tract.
Rev Med Virol, 14 (2004), pp. 17-31
[49.]
A. Antón, A.A. López-Iglesias, T. Tórtola, I. Ruiz-Camps, P. Abrisqueta, L. Llopart, et al.
Selection and viral load kinetics of an oseltamivir-resistant pandemic influenza A (H1N1) virus in an immunocompromised patient during treatment with neuraminidase inhibitors.
Diagn Microbiol Infect Dis, 68 (2010), pp. 214-219
[50.]
H.H. Hirsch, D.C. Brennan, C.B. Drachenberg, F. Ginevri, J. Gordon, A.P. Limaye, et al.
Polyomavirus-associated nephropathy in renal transplantation: interdisciplinary analyses and recommendations.
Transplantation, 79 (2005), pp. 1277-1286
[51.]
A. Ferreira-González, R. Sidiqui.
BK virus in the transplant patient.
Clin Microbiol Newsletter, 29 (2007), pp. 121-128
Copyright © 2012. Elsevier España S.L.. All rights reserved
Descargar PDF
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos