Predisposing Factors to the Development of Urinary Tract Infections in Renal Transplant Recipients and the Impact on the Long-Term Graft function

Abstract

Urinary tract infections (UTIs) represent the most common cause of bacterial infection in renal allograft recipients. The purpose of this study was to estimate the predisposing factors and the impact of UTIs in the long-term graft function. We studied 122 patients (75 males and 47 females), aged 44 ± 12 years. UTIs occurring during the first month, during the first year, and through the entire follow-up period were analyzed. Diabetes mellitus (DM), delayed graft function, acute rejection episodes, and urinary tract obstruction were evaluated as potential predisposing factors. UTI episodes (n = 316) were recorded in 74 of 122 patients (60.7%). The most common pathogen was Escherichia coli. Most patients (81%) who developed infection during the first month had a new episode in the first year. Hospitalization was necessary in 141 of the 316 UTI episodes whereas 87 were hospital acquired. A strong correlation between female gender and UTI occurrence was found (p = 0.01). Urinary tract obstruction was also related to the UTI occurrence during the first year after transplantation (p = 0.001). Patients' age, DM, delayed graft function, and acute rejection episodes did not correlate with UTI. Long-term renal graft function was not found to be affected by UTI occurrence. UTIs are common infectious complications in renal transplant recipients and often relapse and require hospitalization. The long-term graft function is not affected by the occurrence of UTIs.

Antimicrobial Susceptibilities of Uropathogen Escherichia coli in Renal Transplant Recipients: Dramatic Increase in Ciprofloxacin Resistance

“…As in other published articles, E. coli was the most common pathogen in this study. [1][2][3][4][5] Because ciprofloxacin is a commonly prescribed antibiotic for UTI the high resistance rates are worrisome. Comparison of resistance rates in our center demonstrated the ciprofloxacin resistance rates among uropathogenic E. coli to have increased gradually from 30.4% in 2003, 41.3% in 2007, and 59.4% in 2012 (Table 2).…”

“…1 The incidence of UTI after renal transplantation has been reported to be 7.3% in a recent study. 2 These infections may be associated with graft dysfunction.…”

Recurrent Acute Kidney Injury in Renal Transplant Patients: A Single-Center Study

“…UTI are the most common infections observed in renal transplant patients [8,9]. Relapse may occur and hospitalization may be required [8].…”

“…Relapse may occur and hospitalization may be required [8]. Intensive immunosuppressive therapy and ureteral and ureteric catheters are among the factors contributing to the development of UTI [10].…”

Review of Bacterial Urinary Tract Infection in Kidney Transplant Recipients: Incidence, Risk Factors and Impact on the Graft Survival

“…Kidney recipients have the highest risk of developing UTI, with an incidence of 0.45 episodes per 1000 days of transplant and a frequency of 7.3%, followed by kidney-pancreas (5%), heart (2.2%), liver (1.6%) and lung recipients (0.7%) [1]. Other authors described an incidence that ranged from 4% to 75% in renal allograft recipients [2][3][4][5][8][9][10][11]. These differences might be explained by the heterogeneity at establishing the definition of UTI and its clinical manifestations-asymptomatic bacteriuria (AB), acute pyelonephritis (APN), lower UTI, urosepsis, etc., different frequency of routine urine culture testing, different follow-up times, different surgical techniques strategies, diversity in the use of antimicrobial prophylaxis, and in the immunosuppression regimens employed and the retrospective design of most of the studies.…”