Urinary tract infections in renal transplant recipients. 2011

J Gołębiewska, and A Dębska-Ślizień, and J Komarnicka, and A Samet, and B Rutkowski
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland. igolebiewska@gumed.edu.pl

BACKGROUND Urinary tract infections (UTIs) are most common infections in renal transplant recipients and are considered a potential risk factor for poorer graft outcomes. OBJECTIVE To evaluate incidence, clinical manifestations, microbiology, risk factors for UTIs, and the influence of UTIs on long-term renal graft function. METHODS We analyzed urine cultures with reference to clinical data of patients who received a renal transplantation from January to December 2009 with a 12-month follow-up. RESULTS The 1170 urine cultures were correlated with clinical data from 89 renal transplant recipients, including 58.4% males and on overall mean age of 48±14 years. The 151 episodes in 49 patients consisted of asymptomatic bacteriuria (65%, n=98); lower UTIs (13%, n=19); and upper UTIs (22%, n=34), as well as five cases of bacteremia. Nearly 48% of UTIs were diagnosed during the first month posttransplantation. The most frequently isolated uropathogens were Enterococcus faecium (33%, n=24) and Escherichia coli (31%, n=23). Beginning from the second month, most frequently found bacterium in urine cultures was E coli (65% n=51). Risk factors for posttransplant UTIs were female gender and a history of an acute rejection episode and/or a cytomegalovirus (CMV) infection. All patients with vesicoureteral reflux of strictures at the ureterovesical junction suffered recurrent UTIs (n=7). The evolution of renal graft function did not differ significantly between patients with versus without UTIs. CONCLUSIONS UTIs a frequent problem after kidney transplantation most commonly exist as asymptomatic bacteriuria. E coli and E faecium are ther predominant pathogens. Exposure to intensified immunosuppression due to acute rejection episodes or CMV infections represents a risk factor for UTIs. Vesicoureteral reflux or strictures at the ureterovesical junction are risk factors for recurrent UTIs. UTIs did not impair 1-year graft function.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004927 Escherichia coli Infections Infections with bacteria of the species ESCHERICHIA COLI. E coli Infections,E. coli Infection,Infections, E coli,Infections, Escherichia coli,E coli Infection,E. coli Infections,Escherichia coli Infection,Infection, E coli,Infection, E. coli,Infection, Escherichia coli
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001437 Bacteriuria The presence of bacteria in the urine which is normally bacteria-free. These bacteria are from the URINARY TRACT and are not contaminants of the surrounding tissues. Bacteriuria can be symptomatic or asymptomatic. Significant bacteriuria is an indicator of urinary tract infection. Bacteriurias
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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