Objective To understand the microbial culture results of organ preservation solution (PS) and post-transplant infection of recipients. Methods Microbial culture results of organ PS of 485 organ transplant patients in a tertiary hospital in Shanghai from June 2016 to December 2020 were collected retrospectively, according to organ PS culture results, patients were divided into positive group and negative group, positive group were subdivided into different groups according to the distribution of pathogens, infection of different groups within 3 months after transplant was statistically analyzed. Results Among 485 organ transplant patients, 221 cases (45.57%) were PS culture positive, 142 (64.25%) of whom were isolated single kind of pathogen, 54 (24.43%) were isolated two kinds of pathogens, and 25 (11.31%) were isolated ≥ three kinds of pathogens. A total of 327 strains of pathogens were isolated, the top three were coagulase negative staphylococcus (n=67, 20.49%), Klebsiella pneumoniae (n=37, 11.31%) and Escherichia coli (n=27, 8.26%). A total of 47 strains (14.37%) of multidrug-resistant organisms were isolated, including 20 strains (42.55%) of carbapenem-resistant Klebsiella pneumoniae (CRKP) and 18 strains (38.29%) of carbapenem-resistant Acinetobacter baumannii. Infection rate after transplant in positive group was higher than that in negative group (12.22%[27/221] vs 6.82%[18/264]), but difference was not statistically significant (P=0.243); infection rate after transplant in patients with ≥ 3 pathogen group was 32.00% (8/25), which was higher than 9.15% (13/142) in single pathogen group (P=0.004); infection rates of CRKP and Candida albicans positive groups were 45.00% (9/20) and 21.74% (5/23) respectively, which were both higher than 8.20% (15/183) of other pathogen groups (P < 0.001 and P < 0.034, respectively). Conclusion Routine monitoring on organ PS culture results can guide the prevention and control of infection after transplant, if PS culture is positive for CRKP, yeast or Candida, it is recommended to carry out corresponding anti-infection treatment immediately.