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Abstract: FR-PO1148

Diagnostic Yield of Multiplex Polymerase Chain Reaction for Diagnosis of Acute Gastroenteritis in Renal Transplant Recipient: A Single-Center Study from India

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Gupta, Anurag, Sir Ganga Ram Hospital, New Delhi, New Delhi, India
  • Tiwari, Vaibhav, Sir Ganga Ram Hospital, New Delhi, India
  • Anand, Yogeshman, Ganga Ram Hospital, New Delhi, India
  • Rana, Devinder S., Sir Ganga Ram Hospital, New Delhi, India
  • Bhalla, Anil, Sir Ganga Ram Hospital, New Delhi, India
  • Gupta, Ashwani, Sir Ganga Ram Hospital, New Delhi, India
  • Bhargava, Vinant, Sir Ganga Ram Hospital, New Delhi, India
Background

Acute gastroenteritis is an unwelcome and harmful yet unavoidable complication in the renal transplant patient. Standard methods of staining and culture have poor sensitivity as well as require significant time for the reports. Stool Polymerase Chain Reaction is a quick, sensitive and hassle-free method which diagnose more than 20 organisms within 1 hour.

Methods

We retrospectively analyzed all renal transplant patients admitted between 2015 to 2018 with diarrhea. The sample was tested for conventional microbiological methods including stool routine for microscopy and culture. A stool sample was also sent for Multiplex PCR which was analyzed by Bio Fire FilmArray GI Panel which identifies 22 enteropathogens.

Results

110 diarrheal events were recorded in 82 patients with 181 organisms isolated in all samples. 85% sample yielded a positive result. The conventional method yielded a positive result in only 32.3% as compared to stool PCR. Coinfections were common as 71.2% events were associated with 2 or more organisms. Norovirus(20%) was the most common organism isolated from stool followed by Giardia (17%) and Enteropathogenic E.Coli (16%). Giardia Lambia with Norovirus was the most common co-infection in 19% of patients.

Conclusion

Stool PCR significantly improves the diagnostic yield in diagnosing enteric pathogens. Stool PCR is especially sensitive in detecting multiple organisms. Norovirus is the most common enteropathogen. Giardia with Norovirus was the most common co-infection among post-transplant patient.

Frequency of Enteropathogens diagnosed by stool PCR
EnteropathogensNo. of Positive cases (%)
Norovirus37 (20%)
Giardia30 (17%)
Enteropathogenic E.Coli29 (16%)
Cryptosporidium21(12%)
Shigella/Enteroinvasive E.Coli20 (11%)
Others44 (34%)