Posttransplant microbiological surveillance.

Posttransplant microbiological surveillance should be used when the likelihood of infection in a transplant recipient is high and the sensitivity and specificity of the test can provide a high positive or negative predictive value. Testing is also performed in some instances to monitor the patient's response to therapy. Examples of successful posttransplant microbiological surveillance include molecular detection of cytomegalovirus and Epstein-Barr virus and virus load determinations, as well as hepatitis B and C detection and virus load testing. Routine fungal and bacterial surveillance are generally not necessary, except for Candida colonization detection or vancomycin-resistant enterococcal detection in high-risk subgroups. The organ transplanted may also play a role in the type of routine surveillance recommended.