Cytomegalovirus infection management in solid organ transplant recipients across European centers in the time of molecular diagnostics: An ESGICH survey

D. Navarro, R. San-Juan, O. Manuel, E. Gimenez, M. Fernandez-Ruiz, H. H. Hirsch, P. A. Grossi, J. M. Aguado, on behalf of the European Study Group of Infections in Compromised Hosts (ESGICH) from the Society of Clinical Microbiology ESGICH CMV Survey Study Group, Infectious Diseases (ESCMID)

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Scant information is available about how transplant centers are managing their use of quantitative molecular testing (QNAT) assays for active cytomegalovirus (CMV) infection monitoring in solid organ transplant (SOT) recipients. The current study was aimed at gathering information on current practices in the management of CMV infection across European centers in the era of molecular testing assays. METHODS: A questionnaire-based cross-sectional survey study was conducted by the European Study Group of Infections in Immunocompromised Hosts (ESGICH) of the Society of Clinical Microbiology and Infectious Diseases (ESCMID). The invitation and a weekly reminder with a personal link to an Internet service provider (https://es.surveymonkey.com/) was sent to transplant physicians, transplant infectious diseases specialists, and clinical virologists working at 340 European transplant centers. RESULTS: Of the 1181 specialists surveyed, a total of 173 responded (14.8%): 73 transplant physicians, 57 transplant infectious diseases specialists, and 43 virologists from 173 institutions located at 23 different countries. The majority of centers used QNAT assays for active CMV infection monitoring. Most centers preferred commercially available real-time polymerase chain reaction (RT-PCR) assays over laboratory-developed procedures for quantifying CMV DNA load in whole blood or plasma. Use of a wide variety of DNA extraction platforms and RT-PCR assays was reported. All programs used antiviral prophylaxis, preemptive therapy, or both, according to current guidelines. However, the centers used different criteria for starting preemptive antiviral treatment, for monitoring systemic CMV DNA load, and for requesting genotypic assays to detect emerging CMV-resistant variants. CONCLUSIONS: Significant variation in CMV infection management in SOT recipients still remains across European centers in the era of molecular testing. International multicenter studies are required to achieve commutability of CMV testing and antiviral management procedures.
Original languageEnglish
Pages (from-to)10.1111/tid.12773. Epub 2017 Oct 25
JournalTransplant Infectious Disease
Volume19
Issue number6
DOIs
Publication statusPublished - Dec 1 2017

Keywords

  • cytomegalovirus
  • solid organ transplantation
  • survey

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    Navarro, D., San-Juan, R., Manuel, O., Gimenez, E., Fernandez-Ruiz, M., Hirsch, H. H., Grossi, P. A., Aguado, J. M., ESGICH CMV Survey Study Group, O. B. O. T. E. S. G. O. I. I. C. H. ESGICH. F. T. S. O. C. M., & (ESCMID), I. D. (2017). Cytomegalovirus infection management in solid organ transplant recipients across European centers in the time of molecular diagnostics: An ESGICH survey. Transplant Infectious Disease, 19(6), 10.1111/tid.12773. Epub 2017 Oct 25. https://doi.org/10.1111/tid.12773 [doi]