Management of Urinary Tract Infections and Lymphocele in Renal Transplant Recipients

Abstract

The most frequent infectious complication after renal transplantation is urinary tract infection. This article deals with antimicrobial prophylaxis, treatment of early and relapsing urinary tract infections, and management of asymptomatic bacteriuria in renal transplant patients. The incidence of lymphocele after renal transplantation varies, and its treatment is still controversial. Management options are discussed.

Infección del tracto urinario en receptores de trasplante renal

“…Las ITU igualmente se incrementan en mujeres diabéticas, hasta cinco veces más que en las mujeres trasplantadas sin este padecimiento (24) . La diabetes mellitus estuvo presente en cinco de nuestras pacientes (3), destacando el estudio dinámico vesical en ellas y en pacientes añosos (9,28) , que consistió en medir la capacidad vesical máxima, particularmente en aquellos de larga evolución en diálisis con anuria (22,(25)(26)(27) . Corregir las anormalidades anatómicas es la constante en el manejo para minimizar cuadros de ITU.…”

“…Las investigaciones sobre procedimientos invasivos vesicales post trasplante (9,27) encuentran riesgo de incremento de bacteriuria 5 a 10% por día a partir del segundo día de la cateterización vesical (29,30) , además de los problemas técnicos urológicos adicionales como la uretero-neocistostomía (17,27,28,31) . En nuestra serie, 17 (19%) de los 84 receptores contrajeron anormalidades del tracto urinario en el post trasplante, porcentaje elevado si comparamos con otras series (6%) (7,(9)(10)(11)32,33) .…”

Infectious Complications in Kidney Transplantation

“…Accordingly, the use of TMP-SMX is preferred over ciprofloxacin at least during the first 6 months after transplantation. Evidence suggests that late UTIs tend to be benign, without associated bacteremia, metastatic foci or effect on long-term graft function (Munoz, 2001). For this reason, it is recommended to provide prophylaxis for a minimum of 6 months.…”

“…Recognition of the morbidity and mortality associated with allograft pyelonephritis led to recommendations in the 1980s to treat UTIs with as long as a 6-week course of antimicrobials for early UTI following transplantation. More recently, UTI after kidney transplantation has been associated with considerably lower morbidity and mortality (Munoz, 2001). Accordingly, a less-prolonged course may be required, although patients experiencing relapsing infection should be considered for a more prolonged therapeutic course.…”

Bacterial agents of Urinary tract infection in renal allograft recipients and their antimicrobial resistance pattern.

“…Their ability to form biofilm is of particular importance in the development of UTI especially in catheterized patients 8 susceptibility pattern of the infecting microorganisms have been suggested to guide an appropriate antibiotic therapy in post renal transplant patients 10 . The prevalence of drug resistance varies considerably by region and country, thus awareness of local and regional antibiotic susceptibility among uropathogen is recommended to optimize empiric treatment 11 . We assume that, due to social, financial and environmental differences between countries and different transplant centre, the post transplant infectious pattern may be different too; so aims of this study was to find out bacterial agents of UTI and their antimicrobial resistance pattern in post renal transplant patients.…”