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Following solid organ and hematopoietic stem cell transplantation, patients are at increased risk for community-acquired infections, opportunistic and uncommon pathogens, coinfections, and multidrug-resistant organisms. Given the increased predilection for serious infection in this population, diagnostics applicable to the practice of transplant infectious diseases are essential. In the last decade, diagnostic microbiology has witnessed a shift toward culture-independent methods such as molecular testing, mass spectrometry, and magnetic resonance-based technologies that have greatly increased diagnostic capabilities. More recently, another wave of diagnostic modalities including highly multiplexed polymerase chain reaction (PCR) panels directly applicable to clinical specimens and with the potential for resistance detection, metagenomic sequencing, and breath-based diagnosis of volatile metabolites has emerged with significant potential for transplant infectious diseases. At present, many of these technologies continue to have certain drawbacks that limit their applicability, but despite shortcomings, emerging technologies have already demonstrated a diagnostic advantage and a positive impact on patient outcomes. Though data on test performance characteristics and clinical impact among transplant patients remains scarce, it is likely that these modalities will translate into even greater utility given the increased risk for infection in this population. In this review, we examine emerging diagnostic methods for infectious diseases with a focus on the application to transplant patients.

DOI: 10.1007/978-3-030-01751-4_69-1