Infections in the Intensive Care Unit: Posttransplant Infections.
Fiona Winterbottom, Misty Jenkins
PMID 28160960WHAT IT FOUND
In solid organ transplant recipients, usual signs of infection like fever and wound redness are often missing due to immunosuppression.
Nurses must monitor for subtle changes and rely on specific timing windows and risk factors rather than standard inflammatory markers.
Key findings
01Classic clinical markers of infection, including fever, high white blood cell count, and wound redness, are frequently absent in transplant recipients because immunosuppression diminishes the body's inflammatory response.
02The timing of infection after transplant is predictable: bacterial and fungal infections occur in the first month, opportunistic pathogens in months 2 to 6, and community-acquired or rejection-related infections after 6 months.
03Donor-derived infections occur in approximately 0.2% of deceased donor transplants, and recipients of organs from infected donors require a 7- to 10-day course of targeted antibiotics.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a narrative review, not a systematic review or meta-analysis, so it may not capture all available evidence or weigh conflicting studies equally. The paper does not provide a new dataset or primary results, but rather summarizes existing knowledge. Incidence and mortality figures cited are aggregated from various studies with potentially different methodologies and patient populations.
The easy way to misread this
Do not assume a transplant patient is free from infection because they are afebrile or have a normal white blood cell count. Immunosuppression can mask these classic signs, so a low threshold for further investigation is required even when standard markers are absent.