Antimicrobial agents: Edited by Monica A. Slavin, Simon Croft and Deenan PillayAssessment of infection risks prior to lung transplantationLuong, Me-Linha,b; Morrissey, Orlac,d; Husain, Shahida,b Author Information aMultiorgan Transplant Infectious Diseases Division, Canada bDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada cDepartment of Medicine, Monash University, Australia dInfectious Diseases Unit, Alfred Hospital, Melbourne, Victoria, Australia Correspondence to Shahid Husain, MD, Multiorgan Transplant Infectious Diseases Division, University Health Network, University of Toronto, NCSB 11C-1206, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada Tel: +1 416 340 4800 x3144; fax: +1 416 340 5442; e-mail: [email protected] Current Opinion in Infectious Diseases: December 2010 - Volume 23 - Issue 6 - p 578-583 doi: 10.1097/QCO.0b013e32833f9f93 Buy Metrics Abstract Purpose of this review Infections are major causes of morbidity and mortality after lung transplantation. Pretransplant evaluation can identify patients at risk of infectious complications and guide prophylactic strategies post transplantation. This review focuses on studies published from 2006 to the present that relate to the assessment of risk of infection prior to lung transplantation. Recent findings Pretransplant airways colonization with Pseudomonas, Burkholderia, nontuberculosis mycobacteria, Aspergillus and Scedosporium tend to recur after transplantation and cause disease in the lung allograft. Recently, colonization with Pseudomonas and Aspergillus species has been implicated in the subsequent development of allograft dysfunction. B. cenocepacia and Mycobacterium abscessus are particularly associated with poor outcomes after lung transplantation and are considered to be relative contra-indications to lung transplantation in many centers. Tuberculin skin test (TST) has limited value in predicting tuberculosis (TB) reactivation; however, in the absence of a better test, it remains the gold standard for screening patients with latent TB. Serologic screening for histoplasmosis and toxoplasmosis has limited value as these infections rarely occur after lung transplantation. Summary Recurrence of pretransplant airway infection and reactivation of latent infection are potential sources of infection after lung transplantation. Prospective studies are needed to determine the efficacy of prophylactic antimicrobial strategies. © 2010 Lippincott Williams & Wilkins, Inc.