High Incidence of Bacteriuria Following Renal Transplantation in Children

Sharifian, M; Rees, Jon; Trompeter, Richard S.

doi:10.1016/s0022-5347(01)62178-5

Cited by 6 publications

(13 citation statements)

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“…Over 40% of the study population had at least one episode of UTI; 27.4% had more than one episode and another 27.4% had a first UTI episode that was described as a pyelonephritis. The frequency of postKTx UTI in the children enrolled in our study falls within the prevalence rates of 18.7-75.1% reported by other researchers [4,8,9]. Similarly, the frequency of pyelonephritis found in our study is within the prevalence of febrile UTI reported by John et al [4] and Pelle et al [8] in children after KTx .…”

Section: Discussionsupporting

confidence: 90%

“…While some authors have advocated the practice, especially in transplant recipients with known risk factors, such as bladder abnormalities and young age at transplantation, others have reported no benefit [3,9,17]. The optimum duration of antibiotic prophylaxis is also unknown; however, the high frequency of UTI in the first 6 months after KTx suggests a minimum duration of 6 months.…”

Section: Discussionmentioning

confidence: 99%

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Urinary tract infection following kidney transplantation: frequency, risk factors and graft function

2011

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The aim of this study was to determine the proportion of children who develop urinary tract infection (UTI) after kidney transplantation (KTx) and to identify the factors associated with UTI and its impact on graft function. To this end, we undertook a chart review of children who underwent KTx at Red Cross Children's Hospital between January 2003 and December 2009 and were followed-up for at least 6 months after transplantation. Sixty-two children (53.2% males) were followed-up for a mean (standard deviation) period of 36.9 (19.7) months. Mean age at transplantation was 10.0 (4.6) years. Twenty-five (40.3%) children had 89 UTI episodes during the study period, equivalent to 0.94 UTI episodes per one patient-year of follow-up. Acute pyelonephritis occurred in 17 (27.4%) children; another 17 (27.4%) had multiple post-KTx UTI. Klebsiella (40.0%) and Escherichia (28.0%) were the commonest organisms. Those with post-KTx UTI were, at transplantation, younger (8.3 vs. 11.2 years; p = 0.017), had lower urinary tract abnormality (LUTA) (13 vs. 1; p = 0.000) and had pre-KTx UTI (13 vs. 5; p = 0.001). Multivariate analysis revealed that only age <5 years at transplantation and LUTA remained significant and that UTI KTx was not associated with worsening graft function. UTI is common after post-KTx. Among our patient cohort, younger age and LUTA were risk factors, but UTI did not affect graft function.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Urinary tract infection following kidney transplantation: frequency, risk factors and graft function

2011

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“…Urinary-tract infections (UTI) are common in adults [1][2][3][4] and children after renal transplantation [5,6], but are uncommon in children receiving immunosuppression for other reasons [7]. UTI may reduce graft function [6] and should therefore be averted.…”

Section: Introductionmentioning

confidence: 99%

“…UTI may reduce graft function [6] and should therefore be averted. Bladder dysfunction increases the susceptibility to UTI in otherwise healthy children [8,9].…”

Section: Introductionmentioning

confidence: 99%

Bladder dysfunction in children and adolescents after renal transplantation

Herthelius

Öborn

2006

Pediatr Nephrol

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The underlying mechanisms of urinary-tract infections (UTI) in renal transplant recipients are still not fully understood. In otherwise healthy children, bladder dysfunction increases the susceptibility to UTI. The aim of this study was to evaluate lower-urinary-tract function in children and adolescents after renal transplantation. Sixty-eight recipients of renal transplants, 5-20 years of age and 1-15 years after transplantation, were evaluated for their bladder function with a questionnaire, uroflowmetry and bladder ultrasound, and for renal function (glomerular filtration rate) by measuring clearance of inulin or iohexol. Forty-nine patients (72%) had some type of abnormality of bladder function. Abnormal bladder capacity was found in 26%, abnormal urinary flow in 50% and residual urine in 32% of the patients. There was no significant difference in bladder or renal function in children with urinary-tract malformations compared with those with normal urinary tract. Furthermore, there was no significant difference in renal function in patients with bladder dysfunction compared with those without. The incidence of bladder dysfunction is high in children and adolescents after renal transplantation, but the clinical significance of this finding and whether there is a correlation between bladder dysfunction and UTI in these patients need to be clarified further.

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“…Nach einer Nierentransplantation treten Harnwegsinfektionen in 6 bis 85% der Fälle auf [45,47,49]. Eine bakterielle Besiedlung des Urogenitaltraktes wird durch den Harnblasenkatheterismus, Störungen lokaler Abwehrmechanismen infolge immunsuppressiver Therapie, durch einen vesikoureteralen Reflux, vorbestehende Infektion der eigenen Niere, infizierte Spenderorgane oder Perfusionslösungen und durch urologische Komplikationen (Obstruktion, Fistel, ischämische Nekrosen) begünstigt.…”

Section: Asymptomatic Bacteriuriaunclassified

Asymptomatische Bakteriurie

Stein¹,

Fünfstück²

2000

Med Klin

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With the availability of methods to quantitate microbes in urine, one has come to recognize that a certain proportion of apparently healthy individuals have bacteria in their urine in the absence of any clinical symptoms. By definition, asymptomatic bacteriuria is present, if on 1, 2 or more consecutive occasions > 100,000 colony forming units/ml are found in aseptically collected midstream urine, granted that the same microorganism is isolated. Such asymptomatic bacteriuria is found in 2.7% of women aged between 15 and 24 years and increases to 20 to 50% in women above an age of 80 years. In men the prevalence of asymptomatic bacteriuria is considerably lower, but increases to 6 to 20% above the age of 80 years. The microbe most frequently involved in asymptomatic bacteriuria is Escherichia coli, which is characterized by the expression of multiple virulence factors. In this respect they differ from bacteria found in patients with lower or upper urinary tract infections. There is a consensus that in the absence of anatomical or functional abnormalities of the urinary tract asymptomatic bacteriuria per se does not lead to renal scarring, renal dysfunction, or hypertension. The overall prevalence of asymptomatic bacteriuria in pregnancy varies between 2 and 10% with the very small risk of an acute symptomatic episode of urinary tract infection in early pregnancy, but with a substantial risk (30 to 60%) during the last trimester. There is an association between asymptomatic bacteriuria and low birth weight. Asymptomatic bacteriurias are seen in 4 to 60% of immunosuppressed renal graft recipients. The incidence of asymptomatic bacteriuria is also high among patients with diabetes mellitus; the prevalence is approximately 3 fold higher in adult women (7.9 to 11.1%). In these patients asymptomatic bacteriuria does not carry a renal risk. Renal functional prognosis in uncomplicated asymptomatic bacteriuria is excellent. Therefore asymptomatic bacteriuria should be treated during pregnancy, after renal transplantation, prior to urological interventions and in patients with frequent episodes of symptomatic urinary tract infection.

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High Incidence of Bacteriuria Following Renal Transplantation in Children

Cited by 6 publications

References 0 publications

Urinary tract infection following kidney transplantation: frequency, risk factors and graft function

Urinary tract infection following kidney transplantation: frequency, risk factors and graft function

Bladder dysfunction in children and adolescents after renal transplantation

Asymptomatische Bakteriurie

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