Infectious Complications in Kidney Transplant Recipients: A Single-Center Experience

Charfeddine, K.; Zaghden, S; Kharrat, M.; Kamoun, K.; Jarraya, F.; Hachicha, J.

doi:10.1016/j.transproceed.2005.05.009

Cited by 45 publications

(35 citation statements)

References 8 publications

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“…Therefore, the prevalence of infectious episodes in our study might be underestimated. Similar to the scientific literature, [23][24][25][26] the urinary tract was the most-common site of infection in our patients. The prevalence of posttransplant tuberculosis in the present study (1.67%) was within the range reported from other investigations in Iran (1% to 1.4%) 27,28 and Europe (1% to 4%).…”

Section: Discussionsupporting

confidence: 87%

Adverse Reactions of Immunosuppressive Drugs in Iranian Adult Kidney Transplant Recipients

Namazi¹,

Sagheb²,

Karimzadeh³

2012

Exp Clin Transplant

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Objectives: To evaluate the pattern of immunosuppressive drug adverse reactions in adult kidney transplant recipients in Iran Materials and Methods: Adult kidney transplant outpatients under immunosuppressive therapy were recruited into the study. All adverse drug reactions to immunosuppressants and their relevant clinical and paraclinical characteristics were recorded. Causality assessment was performed by the Naranjo algorithm. The seriousness of adverse drug reactions was determined by the World Health Organization definition. The Schumock and Thornton questionnaire was used to assess the preventability of adverse drug reactions. Statistical analyses were performed. Results: A total of 1100 adverse drug reactions were detected from 120 kidney transplant recipients. Increased appetite (9.09%) was the adverse reaction reported most frequently. Causality assessment revealed that 1019 adverse drug reactions (92.64%) were possible. Forty adverse drug reactions (3.64%) were identified as serious. Six hundred seventy-one adverse drug reactions (61%) were preventable. Posttransplant duration was significantly correlated with the number of adverse drug reactions (R=0.19; P = .035). Conclusions: All renal allograft recipients experienced at least 1 immunosuppressant-related adverse reaction. Prolongation of immunosuppressive treatment resulted in an increase in adverse drug reactions.

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Section: Discussionsupporting

confidence: 87%

Adverse Reactions of Immunosuppressive Drugs in Iranian Adult Kidney Transplant Recipients

Namazi¹,

Sagheb²,

Karimzadeh³

2012

Exp Clin Transplant

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“…By 3 yr after transplantation, the cumulative incidence was 60% in adult female recipients and 47% in adult male recipients. Recent articles from single centers have reported similar frequencies, suggesting that the use of Medicare claims reporting is a valid measure (21,22). In our previous study of adults, the occurrence of late UTI Ͼ6 mo after transplantation was associated with a significantly higher AHR for both graft loss and patient death.…”

Section: Discussionmentioning

confidence: 61%

Effects of Urinary Tract Infection on Outcomes after Renal Transplantation in Children

Dharnidharka

Agodoa

Abbott

2007

Clinical Journal of the American Society of Nephrology

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Urinary tract infection (UTI) is the most common infection after kidney transplantation.A previous analysis showed that late (>6 mo after transplantation) UTI is associated with earlier graft loss in adults. It was hypothesized that children who are younger than 18 yr would be at higher risk to develop UTI and develop graft loss after both early and late UTI. The US Renal Data System database was analyzed from 1996 to 2000 for Medicare claims (composite of inpatient and outpatient) for UTI up to 36 mo after transplantation. SPSS software and Cox regression models were used to determine association of UTI and age after adjustment for covariates. Early UTI was defined as occurring <6 mo after transplantation, and late UTI was defined as occurring >6 mo after transplantation. The risk for graft loss after early UTI was elevated in all children (adjusted hazard ratio [AHR] 5.47; 95% confidence interval [CI] 1.93 to 15.4; P < 0.001) but not after late UTI (AHR 2.09; 95% CI 0.56 to 7.80; P ‫؍‬ 0.27). Risk for posttransplantation death was not increased significantly after either early UTI (AHR 1.23; 95% CI 0.37 to 4.08) or late UTI (relative risk 2.22; 95% CI 0.90 to 5.44). Boys aged 2 to 5 (versus age 13 to <18 years) were at significantly higher risk for UTI. In girls, only those in the youngest age category (0 to 1) had higher risk for UTI. Children are at greater risk for graft loss after early but not necessarily late UTI. UTI was not an independent predictor of death in this population.Clin J Am Soc Nephrol 2: 100 -106, 2007. doi: 10.2215/CJN.01820506 I n adults, urinary tract infection (UTI) after renal transplantation has been associated with significant morbidity (1). The use of postoperative antibiotic prophylaxis has reduced dramatically the incidence of UTI after renal transplantation in the past few decades (2,3). Nevertheless, the rates of serious posttransplantation complications that are associated with UTI, such as bacterial septicemia, remain high for patients even in the modern era (4). Most centers generally stop antibiotic prophylaxis within 3 to 6 mo after kidney transplantation in adult and pediatric recipients (5). Late posttransplantation UTI (occurring Ͼ6 mo after transplantation) is widely considered to be "benign" on the basis of data from relatively small studies (6,7). However, more recent studies suggest that even late UTI after renal transplantation has definite risks (8). In adults, we demonstrated from a recent large data analysis of the US Renal Data System (USRDS) that late UTI in adult renal transplant recipients is associated with a higher risk for both graft loss and patient death (8); late UTI may not be as benign as previously believed. However, the impact of posttransplantation UTI on outcomes in children may not be identical to the impact in adults.Children have a different distribution of causes of ESRD, such as a high proportion of congenital lesions such as reflux nephropathy or posterior urethral valves. In addition, primary bladder dysfunction frequently is associated wi...

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“…[4][5][6] In addition to UTIs, sepsis, pneumonia, and surgical field infections are also common. [7][8][9][10] Posttransplant infections create significant morbidity and mortality for affected patients. They also cause prolonged hospital stays, create susceptibility for new infections, and increase treatment costs.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Yabanoğlu

Alışkan²,

Çalışkan³

et al. 2015

Exp Clin Transplant

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Objectives: This study aimed to compare renal transplant recipients with and without infection with respect to demographic and clinical characteristics as well as risk factors; to determine the incidence of posttransplant infections; and to study the antibiotic resistance patterns of bacterial species identified as the causative organisms in posttransplant infections. Materials and Methods: This study included a total of 136 patients undergoing renal transplant in a 4-year period. The patients were categorized into 2 groups. The 2 groups were compared with each other with respect to general clinical and demographic variables and the number and frequency of infectious attacks within a 1-year follow-up, infection type, and antibiotic resistance patterns. Results: Ninety-two (67.6%) of the subjects were male and 44 (32.4%) were female. A total of 57 (41.9%) patients developed 128 infectious attacks. Urinary tract infections were the most common infections (42.1%). There was a significant correlation between a clinically relevant urinary culture proliferation and postoperative infection rate (P = .002). There was a significant correlation between antimicrobial resistance and the number of infectious attacks (P = .023). There was a significant correlation between the proliferation of Extended Spectrum Beta Lactamase-positive Enterobactericeae species and the number of infectious attacks (P = .000). Conclusions: Presence of a clinically relevant proliferation in the preoperative urinary culture, which was identified as a risk factor for infection, increased the number of infectious attacks. Moreover, Extended Spectrum Beta Lactamasepositive Enterobactericeae species increased the number of infections. These 2 principle results should be taken into account in patient management.

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Infectious Complications in Kidney Transplant Recipients: A Single-Center Experience

Cited by 45 publications

References 8 publications

Adverse Reactions of Immunosuppressive Drugs in Iranian Adult Kidney Transplant Recipients

Adverse Reactions of Immunosuppressive Drugs in Iranian Adult Kidney Transplant Recipients

Effects of Urinary Tract Infection on Outcomes after Renal Transplantation in Children

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