*Purpose: Opportunistic infections are responsible for significant morbidity and mortality post-kidney transplant (KT). Recently, medical frailty has been recognized to increase the risk of death both on the waiting list and post transplant. To date, there has not been investigation into the association of medical frailty with opportunistic infection risk.

*Methods: Data for the study came from our center Frailty study, which was conducted between 6/21/2011 and 8/31/2017. Using Frailty as defined by Linda Fried, we measured frailty at first kidney transplant evaluation, each waiting list visit, at transplant and then 3, 6, 12 and 24 months post transplant. Measures included unintentional weight loss, self-reported exhaustion, low physical activity, weakness as measured by grip strength and walking speed. We scored patients 0-5 with 0-1 = non-frail (NF), 2-3 = pre-frail (PF) and 4-5 = frail (F). Among those subjects transplanted, we assessed for any detectable cytomegalovirus (CMV) or BK virus infection over the study period.

*Results: During the study period at total of 568 subjects were enrolled of which 104 progressed to KT. Fifty-nine completed the full 24 month follow up and 50 had complete data suitable to analysis. Subjects were 60% male and 77% white. There were 18 NF, 28 PF and 4 F. There were CMV infections among all groups (5.6% NF, 7.1% PF and 25% of F, respectively). BK infection was noted in 50% NF, 32% PF and 25% of F subjects.

*Conclusions: Although there were limited observations, it appears that frail status is a risk factor for opportunistic infection. Given the morbidity and costs associated with the development of opportunistic infections, continued study to better understand the association and mechanisms that underlie the increased risk of infection are necessary.

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