Causes and Diagnoses

Causes and Diagnoses of Transplant-Related Infections

Most infections that occur after transplant are caused by an overgrowth of bacteria, viruses, fungi and parasites that we normally have in our own bodies. Despite careful screening, infection can sometimes also be introduced by the donated organ. Finally, loved ones and visitors can be a source of infection.

The BK virus, for example, causes an illness like a cold in very young children. After someone has BK virus, it stays dormant or asleep in the kidneys and bladder for the rest of their life. After a transplant, and because of the anti-rejection medicines, the virus “wakes up” in about 5 to 10 percent of kidney transplant patients. We routinely check for BK virus in transplant patients.

Preventing transplant-related infection

In the hospital, our infection control program emphasizes:

• Thorough hand-washing protocol by patients, family members, visitors and health care workers.

• Ongoing checks for resistant microorganisms, in particular, enterococcus, one of the most resistant microorganisms in hospitals today. Each Tuesday, rectal swabs will be performed on all patients in order to identify the presence of resistant microorganisms.

• If you are found to harbor resistant microorganisms, you will be put on special gown and glove isolation so that the resistant organism will not be spread to other patients on the transplant unit.

We ask our transplant patients to:

• Take a bath or shower daily.

• Always wash your hands when visibly soiled, after you use the bathroom, and before and after you eat.

• Wash your hands for 30 to 60 seconds using soap and warm water. Scrub all areas, including between the fingers, under the fingernails, and around the nail beds.

• Use alcohol-based hand-rubs when your hands are not visibly dirty, for example, before and after eating.

• After each bowel or bladder movement, clean thoroughly from front to back. Since patients often develop diarrhea, you may notice tenderness and redness in your rectal area. It is important to notify your nurse and doctor if this occurs.

• Maintain good oral hygiene to help prevent mouth infections. Rinsing with special mouthwashes at least two or three times a day along with brushing your teeth carefully and gently, will further decrease the possibility of developing an infection.

• Change your toothbrush frequently. Old toothbrushes carry many germs that can cause an infection.

• Avoid contact with persons who have a cold, flu or other illness.

• You should not take public transportation right after surgery due to the high risk for developing an infection.

Diagnosing transplant-related infection

If an infection is suspected, the following tests may be conducted to determine the extent of the infection and what is causing it:

• Blood test: A blood sample will be taken to help identify a specific microorganism.

• Chest X-ray: This may spots on your lungs where your immune system is fighting an infection.

• Sputum test: A sample of the mucus you cough up may be tested in a lab for the presence of microorganisms.

• Urine test: A sample of your urine is examined under a microscope for the presence of microorganisms.

• Urine culture: A urine sample is stored in an environment that encourages bacterial growth to help identify what the infectious agent is.

• Stool test: You may be asked to give stool samples to test for infection in the digestive tract.