Clinical Decision Making Made Easy by Multiplex Polymerase Chain Reaction Technology in Case of Life-threatening Infections in Renal Transplant Recipients

Abstract

Post-renal transplant recipients are very vulnerable to severe and life-threatening infections. This is due to ongoing immunosuppression, unusual clinical signs, and frequent involvement of opportunistic or multidrug-resistant organisms. Early and accurate identification of the pathogens, along with their resistance profiles, is crucial for timely and effective treatment. However, this task remains difficult with standard diagnostic methods. This article discusses the use of multiplex polymerase chain reaction (PCR) technology, based on a series of cases involving three renal transplant recipients with severe lung infections. In each case, multiplex PCR performed on bronchoalveolar lavage samples quickly identified the pathogens involved, including bacterial, atypical, and viral agents. It also detected important antimicrobial resistance genes like NDM, VIM, CTX-M, IMP, and OXA-48. The fast availability of these results allowed for targeted antimicrobial treatment, resulting in clinical improvement, successful discharge, and preservation of graft function in all patients. This case series highlights the value of multiplex PCR as a rapid, sensitive, and effective diagnostic tool. It helps inform clinical decisions for critically ill renal transplant patients, especially when quick detection of pathogens and resistance profiling are key to improving outcomes.