Impact of different urinary tract infection phenotypes within the first year post-transplant on renal allograft outcomes

Brune, Jakob E; Dickenmann, Michael; Wehmeier, Caroline; Sidler, Daniel; Walti, Laura N; Golshayan, Déla; Manuel, Oriol; Hadaya, Karine; Neofytos, Dionysios; Schnyder, Aurelia; Boggian, Katia; Müller, Thomas; Schachtner, Thomas; Khanna, Nina; Schaub, Stefan

doi:10.1111/ajt.17026

Cited by 21 publications

(38 citation statements)

References 38 publications

(71 reference statements)

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“…The risk of death from infection is 32 times higher for those who received KT, and mortality due to sepsis is 20-fold higher than that in the general public [ 3 , 16 ]. Several studies have reported that postoperative UTIs in patients undergoing KT are important causes of acute graft dysfunction if not adequately treated [ 2 , 7 , 14 , 17 ]. In addition, recipients who developed rejection are more prone to UTI, and recurrent UTIs in KT recipients are associated with an increased risk of fibrosis of the renal allograft [ 7 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Urine analyses and cultures were performed at each consultation after KT. UTI was defined as the existence of bacterial and/or fungal infection in urine with ≥10 5 colony-forming units/mL with or without urinary and/or systemic symptoms of UTI [ 14 ]. Asymptomatic bacteriuria was defined as the absence of symptoms associated with UTI and a positive urine culture.…”

Section: Methodsmentioning

confidence: 99%

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Diabetes Mellitus as a Predictive Factor for Urinary Tract Infection for Patients Treated with Kidney Transplantation

et al. 2022

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Background and Objectives: We aimed to investigate the rate of incidence and risk factors of post-transplant urinary tract infection (UTI) in patients receiving kidney transplantation (KT) at our institution. Materials and Methods: A retrospective cohort study was carried out on patients who underwent KT for end-stage kidney disease (ESKD) from January 2008 to December 2021 at Gifu University Hospital. UTI was defined as the existence of bacterial and/or fungal infection in urine with ≥105 colony-forming units/mL, with or without urinary and/or systemic symptoms of UTI. Patients were divided into two groups: those with UTI after KT (UTI group) and those without UTI (non-UTI group). The primary endpoint of this study was the relationship between covariates and UTI after KT. Results: Two hundred and forty patients with ESKD received KT at Gifu University Hospital. Thirty-four participants developed UTI after surgery, and the most common pathogen was Escherichia coli. At the end of the follow-up, graft loss was observed in six patients (2.5%), independent of UTI episodes. In the multivariate analysis, diabetes mellitus (DM) was statistically associated with post-transplant UTI in kidney transplant recipients. Conclusions: Preoperative serum glucose control in patients with DM may have a crucial role in preventing UTI and preserving renal function after KT.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Diabetes Mellitus as a Predictive Factor for Urinary Tract Infection for Patients Treated with Kidney Transplantation

et al. 2022

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“…The epidemiology and outcomes of transplant infections have been characterized in detail in several publications of the STCS. Some studies have described the general epidemiology of infection in all patients included in the cohort, 4 whereas others have focused on a specific type of pathogen (e.g., cytomegalovirus and other herpesviruses, 5,6 Aspergillus , 7 Clostridioides difficile 8 ) or on a specific syndrome (e.g., food‐borne infection, 9 urinary tract infection 10 ). In addition to the scientific value, these publications have a pivotal role in quantifying the burden of disease associated with infection, in describing local trends on the epidemiology of specific infections, and in identifying potential unexpected infectious diseases concerns in a particular center 11 .…”

Section: Epidemiology Of Transplant‐infectious Diseases In Switzerlandmentioning

confidence: 99%

Antimicrobial stewardship programs in solid‐organ transplant recipients in Switzerland

Bielicki

Manuel

2022

Transplant Infectious Dis

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Introduction: Antimicrobial stewardship programs (ASPs) are essential for minimizing the emergence of antimicrobial resistance, while improving patient outcomes. The current status of ASP in the field of organ transplantation in Switzerland has not been well characterized. Methods:We describe in this article the current status of ASP and discuss challenges and opportunities of implementing ASP dedicated to solid-organ transplant (SOT) recipients in Switzerland.Results: ASP have been implemented in the Swiss healthcare system over the last years, although specific strategies for SOT recipients are mostly based on transplant infectious diseases (TID) consultations rather than structured institutional interventions. Even so, there is a unique opportunity for developing a successful ASP in Switzerland that also specifically addresses areas of practice relevant to SOT recipients. This is due to the existent network of TID specialists in close collaboration with transplant physicians, the small number of centers involved in the care of transplant recipients, and the development of the Swiss Transplant Cohort Study (STCS), a prospective nationwide cohort of SOT recipients in Switzerland. The STCS can identify actual challenges through the updated reports on the epidemiology on transplant infections, accurately monitor the impact of potential antimicrobial stewardship interventions, and represent an opportunity for nesting of pragmatic randomized controlled trials to address key questions about optimized antibiotic use for SOT recipients. Conclusions:Although ASP in SOT recipients rely more on specific TID consultations than in general antimicrobial stewardship teams, we identified several opportunities for the implementation of a successful ASP in Switzerland.

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“…The reported prevalence of ASB varies greatly depending on the study, population enrolled, time elapsed since KTx, use of antibiotic prophylaxis and length of follow-up from 3% to 50% [ 8 , 10 ]. ASB is the most frequent clinical phenotype in the first month after KTx, after which symptomatic infections predominate and the relative proportion of ASB decreases [ 8 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Asymptomatic Bacteriuria in Kidney Transplant Recipients—A Narrative Review

et al. 2023

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Urinary tract infections (UTIs) are the most prevalent complications in kidney transplant (KTx) recipients. The most frequent finding in this group of patients is asymptomatic bacteriuria (ASB). Here, we provide an overview of the available evidence regarding ASB in KTx recipients, including its etiopathology, clinical impact and management. There is a growing body of evidence from clinical trials that screening for and treating ASB is not beneficial in most KTx recipients. However, there are insufficient data to recommend or discourage the use of a “screen-and-treat strategy” for ASB during the first 1–2 months post-transplant or in the case of an indwelling urinary catheter. Despite its frequency, ASB after KTx is still an understudied phenomenon.

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Impact of different urinary tract infection phenotypes within the first year post-transplant on renal allograft outcomes

Cited by 21 publications

References 38 publications

Diabetes Mellitus as a Predictive Factor for Urinary Tract Infection for Patients Treated with Kidney Transplantation

Diabetes Mellitus as a Predictive Factor for Urinary Tract Infection for Patients Treated with Kidney Transplantation

Antimicrobial stewardship programs in solid‐organ transplant recipients in Switzerland

Asymptomatic Bacteriuria in Kidney Transplant Recipients—A Narrative Review

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