Global challenges of bacterial infections in organ transplantation: assessment of risk factors and predominant bacterial pathogen profiles threatening liver, kidney, heart, and lung transplant recipients.

BACKGROUND

Bacterial infections, especially those caused by multidrug-resistant organisms, remain a major threat to the survival of organ transplant recipients. This review aimed to systematically assess the most common bacterial pathogens, risk factors, and prevention strategies in solid organ transplantation (SOT), focusing on liver, kidney, heart, and lung transplants.

METHODS

A systematic search was conducted across PubMed, Scopus, Web of Science, and Google Scholar databases for studies published between 2015 and 2024. Studies were selected based on inclusion criteria targeting bacterial infections in human transplant recipients. Data were extracted on infection types, bacterial species, risk factors, immunosuppressive regimens, and antimicrobial prophylaxis.

RESULTS

Among 75 eligible articles, 26 met the inclusion criteria. Escherichia coli, Klebsiella spp., and Pseudomonas aeruginosa were the predominant pathogens in most transplant types. Urinary tract infections were most frequent in kidney transplants, while lung, heart, and liver transplant recipients exhibited broader pathogen diversity, including MRSA, VRE, and Acinetobacter. Major risk factors included immunosuppressive therapy, pre-transplant colonization, prolonged ICU stay, and donor-derived MDR organisms. Antibiotic prophylaxis and immunosuppressive regimens varied across studies, with no universal consensus on optimal protocols.

CONCLUSIONS

Bacterial infections significantly impact graft survival and patient outcomes, particularly during the early post-transplant period. Efficient infection prevention, tailored antimicrobial prophylaxis, and optimized immunosuppressive management are essential for improving transplant success rates.