Infectious disease risks in pediatric renal transplantation
Abstract
Renal transplantation is a vital treatment option in children with ESRD with more than 10,000 pediatric kidney transplants and survival rates of greater than 80% at 10 years post-transplant in the USA alone. Despite these advances, infection remains a significant cause of morbidity in pediatric recipients. Screening potential organ donors and recipients is imperative to identify and mitigate infectious risks in the transplant patient. Despite the unique risks of each patient, the timing of many infections post-transplant is predictable. In early post-transplant infections (within 30 days), bacterial and fungal pathogens predominate with donor-derived events and nosocomial infections. In the intermediate period (31–180 days after transplant), latent infections from donor organs, such as EBV and CMV, develop. Late infections occurring > 180 days after the transplant can be due to latent pathogens or community-acquired organisms. Approaching an infectious evaluation in a pediatric kidney recipient requires finesse to diagnose and treat this vulnerable population in a timely manner. The following article highlights the most relevant and common infections including clinical manifestations, risk factors, diagnostic techniques, and treatment options.
Keywords
Pediatric infections Renal transplant Post-transplant infections Infection in immunocompromised childNotes
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
References
- 1.Smith JM, Martz K, Blydt-Hansen TD (2013) Pediatric kidney transplant practice patterns and outcome benchmarks, 1987–2010: a report of the north American pediatric renal trials and collaborative studies. Pediatr Transplant 17:149–157CrossRefPubMedGoogle Scholar
- 2.Ginevri F, De Santis R, Comoli P, Pastorino N, Rossi C, Botti G, Fontana I, Nocera A, Cardillo M, Ciardi M (2003) Polyomavirus BK infection in pediatric kidney-allograft recipients: a single-center analysis of incidence, risk factors, and novel therapeutic approaches. Transplantation 75:1266–1270CrossRefPubMedGoogle Scholar
- 3.Fischer S, Avery R (2009) Screening of donor and recipient prior to solid organ transplantation. Am J Transplant Suppl 4:S7–S18CrossRefGoogle Scholar
- 4.Kasiske BL, Cangro CB, Hariharan S, Hricik DE, Kerman RH, Roth D, Rush DN, Vazquez MA, Weir MR (2001) The evaluation of renal transplantation candidates: clinical practice guidelines. Am J Transplant 1:1–95CrossRefGoogle Scholar
- 5.Ison M, Hager J, Blumberg E, Burdick J, Carney K, Cutler J, Dimaio J, Hasz R, Kuehnert M, Ortiz-Rios E (2009) Donor-derived disease transmission events in the United States: data reviewed by the OPTN/UNOS disease transmission advisory committee. Am J Transplant 9:1929–1935CrossRefPubMedGoogle Scholar
- 6.Kumar D, Humar A (2011) The AST handbook of transplant infections. John Wiley & Sons, West SussixCrossRefGoogle Scholar
- 7.Thall T, Rosh J, Schwersenz A, Eickmeyer D, Fernandez M, Benkov K, LeLeiko N (1994) Primary immunization status in infants referred for liver transplantation. Transplant Proc 26:191PubMedGoogle Scholar
- 8.Linnemann CC, First MR, Schiffman G (1981) Response to pneumococcal vaccine in renal transplant and hemodialysis patients. Arch Intern Med 141:1637–1640CrossRefPubMedGoogle Scholar
- 9.Nikoskelainen J, Koskela M, Forsström J, Kasanen A, Leinonen M (1985) Persistence of antibodies to pneumococcal vaccine in patients with chronic renal failure. Kidney Int 28:672–677CrossRefPubMedGoogle Scholar
- 10.Burroughs M, Moscona A (2000) Immunization of pediatric solid organ transplant candidates and recipients. Clin Infect Dis 30:857–869CrossRefPubMedGoogle Scholar
- 11.Kimberlin, DW, Brady MT, Jackson MA, Long SS (2015) Red book (2015). In: 2015 Report of the committee of infectious diseases. American Academy of Pediatrics, ItascaGoogle Scholar
- 12.Zamora I, Simon JM, Da Silva ME, Piqueras AI (1994) Attenuated varicella virus vaccine in children with renal transplants. Pediatr Nephrol 8:190–192CrossRefPubMedGoogle Scholar
- 13.Scharpé J, Evenepoel P, Maes B, Bammens B, Claes K, Osterhaus A, Vanrenterghem Y, Peetermans W (2008) Influenza vaccination is efficacious and safe in renal transplant recipients. Am J Transplant 8:332–337CrossRefPubMedGoogle Scholar
- 14.Nailescu C, Xu X, Zhou H, Hall H, Wilson AC, Leiser JD, Chand DH, Valentini RP, Hebert D, Mahan JD (2011) Influenza vaccine after pediatric kidney transplant: a Midwest pediatric nephrology consortium study. Pediatr Nephrol 26:459–467CrossRefPubMedGoogle Scholar
- 15.Gabriel R, Selwyn S, Brown D, Crossland J, Loughridge LW, Morgan N, Prosser D, Snow M (1976) Virus infections and acute renal transplant rejection. Nephron 16:282–286CrossRefPubMedGoogle Scholar
- 16.Al-Hasan M, Razonable RR, Eckel-Passow JE, Baddour L (2009) Incidence rate and outcome of gram-negative bloodstream infection in solid organ transplant recipients. Am J Transplant 9:835–843CrossRefPubMedGoogle Scholar
- 17.Ljungman P, Griffiths P, Paya C (2002) Definitions of cytomegalovirus infection and disease in transplant recipients. Clin Infect Dis 34:1094–1097CrossRefPubMedGoogle Scholar
- 18.Alangaden GJ, Thyagarajan R, Gruber SA, Morawski K, Garnick J, El-Amm JM, West MS, Sillix DH, Chandrasekar PH, Haririan A (2006) Infectious complications after kidney transplantation: current epidemiology and associated risk factors. Clin Transpl 20:401–409CrossRefGoogle Scholar
- 19.Fernandes A, Rocha L, Costa T, Matos P, Faria MS, Marques L, Mota C, Henriques AC (2014) Infections following kidney transplant in children: a single-center study. OJNeph 4:117–124CrossRefGoogle Scholar
- 20.Kahwaji J, Bunnapradist S, Hsu J-W, Idroos ML, Dudek R (2011) Cause of death with graft function among renal transplant recipients in an integrated healthcare system. Transplantation 91:225–230CrossRefPubMedGoogle Scholar
- 21.Mueller T, Resinger C, Ruffingshofer D, Arbeiter K, Balzar E, Aufricht C (2003) Urinary tract infections beyond the early post-transplant period in pediatric renal graft recipients. Wien Klin Wochenschr 115:385–388CrossRefPubMedGoogle Scholar
- 22.Adams J, Mehls O, Wiesel M (2004) Pediatric renal transplantation and the dysfunctional bladder. Transpl Int 17:596–602CrossRefPubMedGoogle Scholar
- 23.Saemann MHW (2008) Urinary tract infection in renal transplant recipients. Eur J Clin Investig 38:58–65CrossRefGoogle Scholar
- 24.Sharifian M, Rees L, Trompeter RS (1998) High incidence of bacteriuria following renal transplantation in children. Nephrol Dial Transplant 13:432–435CrossRefPubMedGoogle Scholar
- 25.Parasuraman R, Julian K (2013) Urinary tract infections in solid organ transplantation. Am J Transplant 13:327–336CrossRefPubMedGoogle Scholar
- 26.Mitra S, Alangaden GJ (2011) Recurrent urinary tract infections in kidney transplant recipients. Curr Infect Dis Rep 13:579CrossRefPubMedGoogle Scholar
- 27.Valera B, Gentil M, Cabello V, Fijo J, Cordero E, Cisneros J (2006) Epidemiology of urinary infections in renal transplant recipients. Transplant Proc 38:2414–2415CrossRefPubMedGoogle Scholar
- 28.Group KDIGOTW (2009) KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant Suppl 9:S1–S155Google Scholar
- 29.Rafat C, Vimont S, Ancel P, Xu-Dubois Y, Mesnard L, Ouali N, Denis M, Vandewalle A, Rondeau E, Hertig A (2011) Ofloxacin: new applications for the prevention of urinary tract infections in renal graft recipients. Transpl Infect Dis 13:344–352CrossRefPubMedGoogle Scholar
- 30.Safdar N, Slattery W, Knasinski V, Gangnon R, Li Z, Pirsch J, Andes D (2005) Predictors and outcomes of candiduria in renal transplant recipients. Clin Infect Dis 40:1413–1421CrossRefPubMedGoogle Scholar
- 31.Yazdani M, Foroughifar E, Mohammadi R (2016) Identification of Candida species isolated from renal transplant recipients with candiduria. Int J Organ Transplant Med 7:206–211PubMedPubMedCentralGoogle Scholar
- 32.Fisher JF, Sobel JD, Kauffman CA, Newman CA (2011) Candida urinary tract infections—treatment. Clin Infect Dis 52:S457–S466CrossRefPubMedGoogle Scholar
- 33.Magiorakos AP, Srinivasan A, Carey R, Carmeli Y, Falagas M, Giske C, Harbarth S, Hindler J, Kahlmeter G, Olsson-Liljequist B (2012) Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 18:268–281CrossRefPubMedGoogle Scholar
- 34.Linares L, Cervera C, Cofan F, Ricart M, Esforzado N, Torregrosa V, Oppenheimer F, Campistol J, Marco F, Moreno A (2007) Epidemiology and outcomes of multiple antibiotic–resistant bacterial infection in renal transplantation. Transplant Proc 39:2222–2224CrossRefPubMedGoogle Scholar
- 35.Suwantarat N, Logan LK, Carroll KC, Bonomo RA, Simner PJ, Rudin SD, Milstone AM, Tekle T, Ross T, Tamma PD (2016) The prevalence and molecular epidemiology of multidrug-resistant Enterobacteriaceae colonization in a pediatric intensive care unit. Infect Control Hosp Epidemiol 37:535–543CrossRefPubMedPubMedCentralGoogle Scholar
- 36.Green H, Rahamimov R, Gafter U, Leibovitci L, Paul M (2011) Antibiotic prophylaxis for urinary tract infections in renal transplant recipients: a systematic review and meta-analysis. Transpl Infect Dis 13:441–447CrossRefPubMedGoogle Scholar
- 37.Pouch S, Kubin C, Satlin M, Tsapepas D, Lee J, Dube G, Pereira M (2015) Epidemiology and outcomes of carbapenem-resistant Klebsiella pneumoniae bacteriuria in kidney transplant recipients. Transpl Infect Dis 17:800–809CrossRefPubMedPubMedCentralGoogle Scholar
- 38.Satlin MJ, Kubin CJ, Blumenthal JS, Cohen AB, Furuya EY, Wilson SJ, Jenkins SG, Calfee DP (2011) Comparative effectiveness of aminoglycosides, polymyxin B, and tigecycline for clearance of carbapenem-resistant Klebsiella pneumoniae from the urine. Antimicrob Agents Chemother 55:5893–5899CrossRefPubMedPubMedCentralGoogle Scholar
- 39.Anthony KB, Fishman NO, Linkin DR, Gasink LB, Edelstein PH, Lautenbach E (2008) Clinical and microbiological outcomes of serious infections with multidrug-resistant gram-negative organisms treated with tigecycline. Clin Infect Dis 46:567–570CrossRefPubMedGoogle Scholar
- 40.Tumbarello M, Viale P, Viscoli C, Trecarichi EM, Tumietto F, Marchese A, Spanu T, Ambretti S, Ginocchio F, Cristini F (2012) Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase–producing K. pneumoniae: importance of combination therapy. Clin Infect Dis 55:943–950CrossRefPubMedGoogle Scholar
- 41.Lim T-P, Lee W, Tan T-Y, Sasikala S, Teo J, Hsu L-Y, Tan T-T, Syahidah N, Kwa AL (2011) Effective antibiotics in combination against extreme drug-resistant Pseudomonas aeruginosa with decreased susceptibility to polymyxin B. PLoS One 6:e28177CrossRefPubMedPubMedCentralGoogle Scholar
- 42.Bergen PJ, Tsuji BT, Bulitta JB, Forrest A, Jacob J, Sidjabat HE, Paterson DL, Nation RL, Li J (2011) Synergistic killing of multidrug-resistant Pseudomonas aeruginosa at multiple inocula by colistin combined with doripenem in an in vitro pharmacokinetic/pharmacodynamic model. Antimicrob Agents Chemother 55:5685–5695CrossRefPubMedPubMedCentralGoogle Scholar
- 43.Moore C, Davis NF, Burke JP, Power R, Mohan P, Hickey D, Smyth G, Eng M, Little DM (2014) Colonisation with methicillin-resistant Staphylococcus aureus prior to renal transplantation is associated with long-term renal allograft failure. Transpl Int 27:926–930CrossRefPubMedGoogle Scholar
- 44.Freitas MCS, Pacheco-Silva A, Barbosa D, Silbert S, Sader H, Sesso R, Camargo LFA (2006) Prevalence of vancomycin-resistant Enterococcus fecal colonization among kidney transplant patients. BMC Infect Dis 6:133CrossRefPubMedPubMedCentralGoogle Scholar
- 45.Tokars JI, Gehr T, Jarvis WR, Anderson J, Armistead N, Miller ER, Parrish J, Qaiyumi S, Arduino M, Holt SC (2001) Vancomycin-resistant enterococci colonization in patients at seven hemodialysis centers. Kidney Int 60:1511–1516CrossRefPubMedGoogle Scholar
- 46.von Baum H, Schehl J, Geiss HK, Schaefer F (1999) Prevalence of vancomycin-resistant enterococci among children with end-stage renal failure. Clin Infect Dis 29:912–916CrossRefGoogle Scholar
- 47.Flokas ME, Karageorgos SA, Detsis M, Alevizakos M, Mylonakis E (2017) Vancomycin-resistant enterococci colonisation, risk factors and risk for infection among hospitalised paediatric patients: a systematic review and meta-analysis. Int J Antimicrob Agents 49:565–572CrossRefPubMedGoogle Scholar
- 48.Beam E, Razonable RR (2012) Cytomegalovirus in solid organ transplantation: epidemiology, prevention, and treatment. Curr Infect Dis Rep 14:633–641CrossRefPubMedGoogle Scholar
- 49.Sagedal S, Nordal KP, Hartmann A, Degré M, Holter E, Foss A, Osnes K, Leivestad T, Fauchald P, Rollag H (2000) A prospective study of the natural course of cytomegalovirus infection and disease in renal allograft RECIPIENTS1. Transplantation 70:1166–1174CrossRefPubMedGoogle Scholar
- 50.Neu, A.M, Dharnidharka, V.R. (2008) Prevention and treatment of infectious complications in pediatric renal allograft recipients. In: Comprehensive pediatric nephrology. Mosby-Elsevier, Philadelphia, pp 967–975Google Scholar
- 51.Höcker B, Zencke S, Krupka K, Fichtner A, Pape L, Strologo LD, Guzzo I, Topaloglu R, Kranz B, König J (2016) Cytomegalovirus infection in pediatric renal transplantation and the impact of chemoprophylaxis with (val-) ganciclovir. Transplantation 100:862–870CrossRefPubMedGoogle Scholar
- 52.Höcker B, Zencke S, Pape L, Krupka K, Köster L, Fichtner A, Dello Strologo L, Guzzo I, Topaloglu R, Kranz B (2016) Impact of Everolimus and low-dose Cyclosporin on cytomegalovirus replication and disease in pediatric renal transplantation. Am J Transplant 16:921–929CrossRefPubMedGoogle Scholar
- 53.Humar A, Gregson D, Caliendo AM, McGeer A, Malkan G, Krajden M, Corey P, Greig P, Walmsley S, Levy G (1999) Clinical utility of quantitative cytomegalovirus viral load determination for predicting cytomegalovirus disease in liver transplant recipients. Transplantation 68:1305–1311CrossRefPubMedGoogle Scholar
- 54.Khoury J, Storch G, Bohl D, Schuessler R, Torrence S, Lockwood M, Gaudreault-Keener M, Koch M, Miller B, Hardinger K (2006) Prophylactic versus preemptive oral valganciclovir for the management of cytomegalovirus infection in adult renal transplant recipients. Am J Transplant 6:2134–2143CrossRefPubMedGoogle Scholar
- 55.Cameron BM, Kennedy SE, Rawlinson WD, Mackie FE (2017) The efficacy of valganciclovir for prevention of infections with cytomegalovirus and Epstein-Barr virus after kidney transplant in children. Pediatr Transplant. https://doi.org/10.1111/petr.12816
- 56.Erdbruegger U, Scheffner I, Mengel M, Schwarz A, Haller H, Gwinner W (2015) Long-term impact of CMV infection on allografts and on patient survival in renal transplant patients with protocol biopsies. Am J Physiol Renal Physiol 309:F925–F932CrossRefGoogle Scholar
- 57.Åsberg A, Humar A, Rollag H, Jardine AG, Mouas H, Pescovitz MD, Sgarabotto D, Tuncer M, Noronha I, Hartmann A (2007) Oral valganciclovir is noninferior to intravenous ganciclovir for the treatment of cytomegalovirus disease in solid organ transplant recipients. Am J Transplant 7:2106–2113CrossRefPubMedGoogle Scholar
- 58.Lurain NS, Chou S (2010) Antiviral drug resistance of human cytomegalovirus. Clin Microbiol Rev 23:689–712CrossRefPubMedPubMedCentralGoogle Scholar
- 59.Maertens J, Cordonnier C, Jaksch P, Poiré X, Wu JJ, Wijatyk A, Saliba F, Witzke O, Villano S (2016) Maribavir versus Valganciclovir for preemptive treatment of cytomegalovirus (CMV) viremia: a randomized, dose-ranging, phase 2 study among hematopoietic stem cell transplant (SCT) and solid organ transplant (SOT) recipients. Open Forum Infect Dis. https://doi.org/10.1093/ofid/ofw172.1834
- 60.Marty FM, Ljungman P, Chemaly RF, Maertens J, Dadwal SS, Duarte RF, Haider S, Ullmann AJ, Katayama Y, Brown J (2017) Letermovir prophylaxis for cytomegalovirus in hematopoietic-cell transplantation. N Engl J Med 377:2433–2444CrossRefPubMedGoogle Scholar
- 61.Arasaratnam RJ, Leen AM (2015) Adoptive T cell therapy for the treatment of viral infections. Ann Transl Med 3:278PubMedPubMedCentralGoogle Scholar
- 62.Haque T, Wilkie GM, Jones MM, Higgins CD, Urquhart G, Wingate P, Burns D, McAulay K, Turner M, Bellamy C (2007) Allogeneic cytotoxic T-cell therapy for EBV-positive posttransplantation lymphoproliferative disease: results of a phase 2 multicenter clinical trial. Blood 110:1123–1131CrossRefPubMedGoogle Scholar
- 63.Allen UD (2005) The ABC of Epstein-Barr virus infections. In: Pollard AJ, Finn A (eds) Hot topics in infection and immunity in children II. Advances in experimental medicine and biology, vol 568. Springer, Boston, pp 25–39Google Scholar
- 64.Nourse J, Jones K, Gandhi M (2011) Epstein–Barr virus-related post-transplant lymphoproliferative disorders: pathogenetic insights for targeted therapy. Am J Transplant 11:888–895CrossRefPubMedGoogle Scholar
- 65.Parker A, Bowles K, Bradley JA, Emery V, Featherstone C, Gupte G, Marcus R, Parameshwar J, Ramsay A, Newstead C (2010) Diagnosis of post-transplant lymphoproliferative disorder in solid organ transplant recipients–BCSH and BTS guidelines. Br J Haematol 149:675–692CrossRefPubMedGoogle Scholar
- 66.Dharnidharka V, Martz K, Stablein D, Benfield M (2011) Improved survival with recent post-transplant lymphoproliferative disorder (PTLD) in children with kidney transplants. Am J Transplant 11:751–758CrossRefPubMedGoogle Scholar
- 67.Hebert D, Sullivan E (1998) Malignancy and post transplant lymphoproliferative disorder in pediatric renal transplant recipients: a report of the North American Pediatric Renal Transplant Cooperative Study. Pediatr Transplant 2:11: 50–11:59Google Scholar
- 68.Schober T, Framke T, Kreipe H, Schulz TF, Grohennig A, Hussein K, Baumann U, Pape L, Schubert S, Wingen A-M (2013) Characteristics of early and late PTLD development in pediatric solid organ transplant recipients. Transplantation 95:240–246CrossRefPubMedGoogle Scholar
- 69.AlDabbagh MA, Gitman MR, Kumar D, Humar A, Rotstein C, Husain S (2017) The role of antiviral prophylaxis for the prevention of Epstein–Barr virus–associated Posttransplant lymphoproliferative disease in solid organ transplant recipients: a systematic review. Am J Transplant 17:770–781CrossRefPubMedGoogle Scholar
- 70.Opelz G, Daniel V, Naujokat C, Fickenscher H, Döhler B (2007) Effect of cytomegalovirus prophylaxis with immunoglobulin or with antiviral drugs on post-transplant non-Hodgkin lymphoma: a multicentre retrospective analysis. Lancet Oncol 8:212–218CrossRefPubMedGoogle Scholar
- 71.Green M, Michaels M, Katz B, Burroughs M, Gerber D, Shneider B, Newell K, Rowe D, Reyes J (2006) CMV-IVIG for prevention of Epstein Barr virus disease and posttransplant lymphoproliferative disease in pediatric liver transplant recipients. Am J Transplant 6:1906–1912CrossRefPubMedGoogle Scholar
- 72.Antonsson A, Green AC, Mallitt K-A, O'Rourke PK, Pawlita M, Waterboer T, Neale RE (2010) Prevalence and stability of antibodies to the BK and JC polyomaviruses: a long-term longitudinal study of Australians. J Gen Virol 91:1849–1853CrossRefPubMedGoogle Scholar
- 73.Drachenberg CB, Hirsch HH, Papadimitriou JC, Gosert R, Wali RK, Munivenkatappa R, Nogueira J, Cangro CB, Haririan A, Mendley S (2007) Polyomavirus BK versus JC replication and nephropathy in renal transplant recipients: a prospective evaluation. Transplantation 84:323–330CrossRefPubMedGoogle Scholar
- 74.Hirsch HH, Knowles W, Dickenmann M, Passweg J, Klimkait T, Mihatsch MJ, Steiger J (2002) Prospective study of polyomavirus type BK replication and nephropathy in renal-transplant recipients. N Engl J Med 347:488–496CrossRefPubMedGoogle Scholar
- 75.Smith JM, Dharnidharka VR, Talley L, Martz K, McDonald RA (2007) BK virus nephropathy in pediatric renal transplant recipients: an analysis of the north American pediatric renal trials and collaborative studies (NAPRTCS) registry. Clin J Am Soc Nephrol 2:1037–1042CrossRefPubMedGoogle Scholar
- 76.Puliyanda DP, Toyoda M, Traum AZ, Flores FX, Jordan S, Moudgil A, Somers MJ (2008) Outcome of management strategies for BK virus replication in pediatric renal transplant recipients. Pediatr Transplant 12:180–186CrossRefPubMedGoogle Scholar
- 77.Araya CE, Garin EH, Neiberger RE, Dharnidharka VR (2010) Leflunomide therapy for BK virus allograft nephropathy in pediatric and young adult kidney transplant recipients. Pediatr Transplant 14:145–150CrossRefPubMedGoogle Scholar
- 78.Kable K, Davies CD, O'connell PJ, Chapman JR, Nankivell BJ (2017) Clearance of BK virus nephropathy by combination antiviral therapy with intravenous immunoglobulin. Transplant Direct. https://doi.org/10.1097/TXD.0000000000000641
- 79.Bunnapradist S, Neri L, Wong W, Lentine KL, Burroughs TE, Pinsky BW, Takemoto SK, Schnitzler MA (2008) Incidence and risk factors for diarrhea following kidney transplantation and association with graft loss and mortality. Am J Kidney Dis 51:478–486CrossRefPubMedGoogle Scholar
- 80.Maes B, Hadaya K, De Moor B, Cambier P, Peeters P, De Meester J, Donck J, Sennesael J, Squifflet JP (2006) Severe diarrhea in renal transplant patients: results of the DIDACT study. Am J Transplant 6:1466–1472CrossRefPubMedGoogle Scholar
- 81.Ciricillo J, Haslam D, Blum S, Kim MO, Liu C, Paulsen G, Courter J, Danziger-Isakov L (2016) Frequency and risks associated with Clostridium difficile-associated diarrhea after pediatric solid organ transplantation: a single-center retrospective review. Transpl Infect Dis 18:706–713CrossRefPubMedGoogle Scholar
- 82.Boutros M, Al-Shaibi M, Chan G, Cantarovich M, Rahme E, Paraskevas S, Deschenes M, Ghali P, Wong P, Fernandez M (2012) Clostridium difficile colitis: increasing incidence, risk factors, and outcomes in solid organ transplant recipients. Transplantation 93:1051–1057CrossRefPubMedGoogle Scholar
- 83.Riddle DJ, Dubberke ER (2008) Clostridium difficile infection in solid organ transplant recipients. Curr Opin Organ Transplant 13:592–600CrossRefPubMedGoogle Scholar
- 84.Kelly CR, Ihunnah C, Fischer M, Khoruts A, Surawicz C, Afzali A, Aroniadis O, Barto A, Borody T, Giovanelli A (2014) Fecal microbiota transplant for treatment of Clostridium difficile infection in immunocompromised patients. Am J Gastroenterol 109:1065–1071CrossRefPubMedPubMedCentralGoogle Scholar
- 85.Roos-Weil D, Ambert-Balay K, Lanternier F, Mamzer-Bruneel M-F, Nochy D, Pothier P, Avettand-Fenoel V, Anglicheau D, Snanoudj R, Bererhi L (2011) Impact of norovirus/sapovirus-related diarrhea in renal transplant recipients hospitalized for diarrhea. Transplantation 92:61–69CrossRefPubMedGoogle Scholar
- 86.Azami M, Sharifi M, Hejazi SH, Tazhibi M (2010) Intestinal parasitic infections in renal transplant recipients. Braz J Infect Dis 14:15–18CrossRefPubMedGoogle Scholar
- 87.Bandin F, Kwon T, Linas M-D, Guigonis V, Valentin A, Cassaing S, Carol A, Garnier A, Baudouin V, Decramer S (2009) Cryptosporidiosis in paediatric renal transplantation. Pediatr Nephrol 24:2245–2255CrossRefPubMedGoogle Scholar
- 88.Kristjansson M, Bieluch VM, Byeff PD (1991) Mycobacterium haemophilum infection in immunocompromised patients: case report and review of the literature. Rev Infect Dis 13:906–910CrossRefPubMedGoogle Scholar
- 89.da Cunha S, Ferreira E, Ramos I, Martins R, de Freitas L, Borges J, Côrte-Real R, Mota A, Meliço-Silvestre A, Linhares-Furtado A (1993) Cerebral toxoplasmosis in a kidney transplant patient. A clinical case and review of the literature. Acta Medica Port 6:157–163Google Scholar
- 90.Boggild AK, Geduld J, Libman M, Yansouni CP, McCarthy AE, Hajek J, Ghesquiere W, Mirzanejad Y, Vincelette J, Kuhn S (2017) Surveillance report of Zika virus among Canadian travellers returning from the Americas. Can Med Assoc J 189:E334–E340CrossRefGoogle Scholar
- 91.Nogueira M, Estofolete C, Terzian A, Mascarin do Vale E, Silva R, Silva R, Ramalho H, Fernandes Charpiot I, Vasilakis N, Abbud-Filho M (2017) Zika virus infection and solid organ transplantation: a new challenge. Am J Transplant 17:791–795CrossRefPubMedGoogle Scholar
- 92.Kotton CN (2016) Zika virus and solid organ transplantation: significant pathogen or harbinger of things to come? Transplantation 100:970–972CrossRefPubMedGoogle Scholar
- 93.Simkins J, Anjan S, Morillas-Rodriguez J, Greissman S, Abbo L, Camargo J, Ruiz P, Vianna R, Guerra G, Salama S (2017) Screening for Zika virus in deceased organ donors in Florida. Am J Transplant. https://doi.org/10.1111/ajt.14582