Association between acute graft pyelonephritis and kidney graft survival: A single-center observational study

Maanaoui, Mehdi; Baes, Dulciane; Hamroun, Aghilès; Khedjat, Kahina; Vuotto, Fanny; Faure, Emmanuel; López, Benjamín; Bouyé, S.; Caes, T.; Lionet, Arnaud; Lebas, C.; François, Patrice; Guilhot, François; Gibier, Jean‐Baptiste; Lenain, Rémi; Hazzan, Marc

doi:10.1111/ajt.16703

Cited by 13 publications

(17 citation statements)

References 31 publications

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“…Urinary tract infections (UTIs) are the most common infectious complication in kidney transplant (KT) recipients, especially in the first months after transplantation [ 4 , 5 , 6 ]. Acute graft pyelonephritis (AGP) is the most severe manifestation of UTI in this population, with an estimated rate between 10 and 20% [ 4 , 7 , 8 , 9 ], and is the leading cause of BSI in KT recipients [ 4 , 5 , 9 , 10 ]. Moreover, AGP has been associated with kidney graft function impairment, graft loss, and mortality [ 9 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Acute graft pyelonephritis (AGP) is the most severe manifestation of UTI in this population, with an estimated rate between 10 and 20% [ 4 , 7 , 8 , 9 ], and is the leading cause of BSI in KT recipients [ 4 , 5 , 9 , 10 ]. Moreover, AGP has been associated with kidney graft function impairment, graft loss, and mortality [ 9 , 11 , 12 , 13 ]. New measures are needed to improve the management of AGP after KT.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors and Outcomes of Acute Graft Pyelonephritis with Bacteremia Due to Multidrug-Resistant Gram-Negative Bacilli among Kidney Transplant Recipients

Sabé

Maristany

Tuells

et al. 2022

JCM

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Acute graft pyelonephritis (AGP) is the leading cause of bloodstream infection in kidney transplant (KT) recipients. The prevalence of urinary tract infections caused by multidrug-resistant (MDR) Gram-negative bacilli is increasing. This 14-year prospective observational study sought to determine the clinical characteristics, risk factors, and outcomes of AGP with bacteremia due to MDR Gram-negative bacilli. Overall, 278 episodes of AGP with bacteremia due to MDR Gram-negative and non-MDR Gram-negative bacilli were identified and compared in 214 KT recipients; MDR Gram-negative bacilli were the cause in 28.4%. Overall 30-day mortality was low (1.1%). Risk factors independently associated with AGP due to MDR Gram-negative bacilli were male sex (OR 3.08; 95%CI 1.60–5.93), previous episode of bacteremic AGP (OR 2.11, 95%CI 1.09–4.09), prior antibiotic therapy in the preceding month (OR 2.47, 95%CI 1.33–4.57), and nosocomial acquisition (OR 2.03, 95%CI 1.14–3.62). Forty-three percent of MDR Gram-negative episodes received inappropriate empirical antibiotic therapy. The risk factors identified in this study may help physicians when selecting empirical antibiotic treatment for AGP. Previous antibiotic use was the main modifiable factor. Its presence highlights the importance of avoiding unnecessary antibiotics in order to bring down the high rates of MDR Gram-negative bacilli infections in this population.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk Factors and Outcomes of Acute Graft Pyelonephritis with Bacteremia Due to Multidrug-Resistant Gram-Negative Bacilli among Kidney Transplant Recipients

Sabé

Maristany

Tuells

et al. 2022

JCM

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“…When compared to patients without infections, patients with transplant pyelonephritis had an approximately 1.5‐fold higher risk for mortality (aHR 1.49, 95% CI 1.44–1.54) and graft loss (aHR 1.65, 95% CI 1.56–1.75) 2 . Graft loss associated with acute pyelonephritis was further confirmed in a single‐center study of 1480 kidney transplant recipients (aHR 1.66; 95% CI: 1.05–2.64) 3 …”

Section: Introductionmentioning

confidence: 79%

“…2 Graft loss associated with acute pyelonephritis was further confirmed in a singlecenter study of 1480 kidney transplant recipients (aHR 1.66; 95% CI: 1.05-2.64). 3 Despite the frequency and the consequences of acute graft pyelonephritis, the optimal antibiotic treatment duration has not yet been established. In non-transplant patients, a 7-day duration for acute native kidney pyelonephritis is recommended in the 2010 IDSA guidelines, but transplant pyelonephritis is not addressed.…”

Section: Introductionmentioning

confidence: 99%

Duration of antibiotic treatment for acute graft pyelonephritis: What's the standard of care?

Kumar

Pereira

Taimur

et al. 2022

Transplant Infectious Dis

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Background Limited evidence is available to inform the duration of antibiotic treatment in kidney transplant recipients with bacterial acute graft pyelonephritis. Guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation suggest a 14–21 day duration. Methods A four‐question survey was constructed to determine the current standard of practice for the duration of treatment for acute graft pyelonephritis. The survey was distributed among members of the Infectious Diseases and the Kidney Pancreas Communities of Practice of the American Society of Transplantation. Results Among 144 survey respondents, 87 (60%) were infectious disease physicians, and 36 (25%) were transplant nephrologists. Although most (55%) respondents preferred a 14‐day duration, a spread between 7 and 28 days was observed. Goals of treatment and drivers for longer duration differed between infectious disease physicians and transplant nephrologists. Conclusions Although most respondents prefer a 14‐day duration of treatment for acute graft pyelonephritis, a wide range of responses was seen between 7 and 28 days. More evidence is needed to inform optimal treatment duration in this common infectious complication after transplantation.

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“…However, urinary tract infections such as graft pyelonephritis occurrence have not been associated with induction regimen or steroids exposure in previous studies either. 19 , 20 , 21 Because renal cyst infection are generally associated with higher kidney volume, 22 it is possible that the natural decrease in native kidney volume, observed mainly within the first year after renal transplantation, 23 also played a role in renal cyst infection after the first year of transplantation.…”

Section: Discussionmentioning

confidence: 99%

Incidence, Risk Factors and Outcomes of Kidney and Liver Cyst Infection in Kidney Transplant Recipient With ADPKD

Ronsin

Chaba²,

Suchánek

et al. 2022

Kidney International Reports

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

Association between acute graft pyelonephritis and kidney graft survival: A single-center observational study

Cited by 13 publications

References 31 publications

Risk Factors and Outcomes of Acute Graft Pyelonephritis with Bacteremia Due to Multidrug-Resistant Gram-Negative Bacilli among Kidney Transplant Recipients

Risk Factors and Outcomes of Acute Graft Pyelonephritis with Bacteremia Due to Multidrug-Resistant Gram-Negative Bacilli among Kidney Transplant Recipients

Duration of antibiotic treatment for acute graft pyelonephritis: What's the standard of care?

Incidence, Risk Factors and Outcomes of Kidney and Liver Cyst Infection in Kidney Transplant Recipient With ADPKD

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