Updates on urinary tract infections in kidney transplantation

Fiorentino, Marco; Pesce, Francesco; Schena, Antonio; Simone, Simona; Castellano, Giuseppe; Gesualdo, Loreto

doi:10.1007/s40620-019-00585-3

Cited by 56 publications

(59 citation statements)

References 81 publications

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“…The Gram-negative bacteria (Enterobacteriaceae) were identified by indole production, H2S production, lactose fermentation in triple sugar iron agar, citrate utilization, motility test, urease test, bile solubility, utilization of lysine in lysine decarboxylase agar. Oxidase test was also performed for non-fermenter Gram-negative rods.The Gram-positive bacteria were identified using routine bench tests such as catalase, coagulase and bile-esculin tests [3,16].…”

Section: Bacterial Culture and Identificationsmentioning

confidence: 99%

“…The globally reported prevalence of post-renal transplantation urinary tract infection may vary depending on several factors and conditions such the study design, selection of antimicrobial prophylaxis and lack of advanced diagnostic facility to track post-renal transplantation urinary tract infection. Hence, many authors described that it ranged from 4% to 75% [3]. Likewise, the overall incidence of UTI in solid organ transplant recipients was reported 0.23 episodes/1000 days of transplant.…”

Section: Introductionmentioning

confidence: 99%

“…Several factors may contribute to kidney allograft loss and grave outcome impacts. These include anatomical factors, surgical factors, microbial factors and allograft factors [3,[10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Bacterial Urinary Tract Infection among Adult Renal Transplant Recipients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Kiros

Asrat

Ayenew

et al. 2019

Preprint

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Background: Despite significant advances in surgical techniques, immunosuppression protocols follow up periods and antimicrobial stewardship in modern medicine; post-renal transplantation urinary tract infection remained a major public health problem globally. This multiple serious squeal includes asymptomatic bacteriuria, cystitis and pyelonephritis. Among these, the bacterial origin of infection complications accounts for the most significant clinical, socio-economic impacts in many countries of the world. Therefore, the aim of the study was to investigate the prevalence of bacterial isolates that cause urinary tract infections, assess antibiotic susceptibility pattern among symptomatic and asymptomatic renal transplant recipients attending at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: A hospital-based cross-sectional study was conducted from December 2017 to August 2018 among 74 renal transplant recipients St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. A first morning voided clean-catch mid-stream urine specimens were collected and 0.001ml inoculated onto blood and MacConkey agar plates following the standard bacteriological protocols. It was incubated aerobically at 35–37°C for 24–48 hours. Cultural characteristics and series of biochemical tests were used for the identification of isolates to species level. Results: Significant bacteriuria was found in 11/74 (14.9%, 95% CI =8.2-24.7) patients. The prevalence among females 6/32 (18.75%) was higher among males 5/42 (11.9%) without significant association (COR=2.09, 95% CI=1.04-8.45, P=0.253). Urinary tract infection was higher in the age group of 35–49 years old (19.3%). Age was statistically significant and stronger independent associated risk factor with crude odds ratio=3.67, 95% CI=2.89-20.07 and P= 0.003, respectively. The most prevalent bacteria isolates were Escherichia coli 2(18.2%), Staphylococcus aureus 2(18.2%), Acinetobacter spp. 2(18.2%), Enterococcus spp. 2(18.2%), Coagulase-negative Staphylococci 2(18.2%) followed by Portus mirabilis 1(9.1%). The majority (80%) of Gram-negative bacteria were resistant to ciprofloxacin, chloramphenicol, and trimethoprim/sulfamethoxazole. Conclusions: In conclusion, the overall prevalence of urinary tract infection in the study participants was relatively low with a prevalence of 14.9%. Majority of the study participants were asymptomatic. The multidrug-resistant bacterial isolates in the present study account for 82%. Keywords: Kidney Transplantation, Urinary Tract Infection, Antimicrobial Susceptibility Testing, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.

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Section: Bacterial Culture and Identificationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bacterial Urinary Tract Infection among Adult Renal Transplant Recipients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Kiros

Asrat

Ayenew

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…The globally reported prevalence of post-renal transplantation urinary tract infection may vary depending the study design, immune suppression protocol, surgical protocol and diversity in the use of antimicrobial prophylaxis. However, incidence varies depending on the type of transplanted organ being the renal transplants are the highest risk groups among any other organ transplants [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Bacterial urinary tract infection among adult renal transplant recipients at St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia

et al. 2019

View full text Add to dashboard Cite

Background: Despite significant advances in surgical techniques, immunosuppression protocols, follow up periods and antimicrobial stewardship in modern medicine; post-renal transplantation urinary tract infection remained a major public health problem globally. This multiple serious squeals includes asymptomatic bacteriuria, cystitis and pyelonephritis. Among these, the bacterial origin of infection complications accounts for the most significant clinical, socioeconomic impacts in many countries of the world. Therefore, the aim of the study was to investigate the prevalence of bacterial isolates that cause urinary tract infections, assess antibiotic susceptibility pattern among symptomatic and asymptomatic renal transplant recipients attending at

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“…It is well documented in the recent literature that asymptomatic carrier stages with potentially pathogenic bacteria in urine exist, but which pose no specific threat to human health [6]. From previous research we know that a broad gamut of bacterial genera represent a steadily fluctuating flora in the urinary bladder [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

The urinary microbiome shows different bacterial genera in renal transplant recipients and non-transplant patients at time of acute kidney injury – a pilot study

et al. 2020

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Background: In the past urine was considered sterile. Through the introduction of next generation sequencing, it has become clear that a urinary microbiome exists. Acute kidney injury (AKI) represents a major threat to kidney transplant recipients. Remarkable changes in the urinary metabolome occur during AKI, which may influence the urinary microbiome. To our knowledge, this is the first study that examines the urinary microbiome in renal transplant recipients (RTX) and non-transplant recipients (nRTX) at time of AKI.Methods: In this cross-sectional pilot-study the urinary microbiome of 21 RTX and 9 nRTX with AKI was examined. Clean catch morning urine samples were obtained from all patients on the first day of AKI diagnosis. AKI was defined according to KDIGO guidelines. Urinary microbiota and the urinary metabolome during AKI were assessed in one patient. 16S rRNA sequencing was performed. Sequences were processed using UPARSE-pipeline for operational taxonomic units (OTU) and taxon finding. Results: We successfully extracted and sequenced bacterial DNA from 100% of the urine samples. All 30 patients revealed at least 106,138 reads. 319 OTU and 211 different genera were identified. The microbiotic diversity richness in the RTX group was no different from the nRTX group. Eighteen genera were solely present in nRTX and 7 in RTX. Conclusions: The urinary microbiome at time of AKI showed different bacterial genera in RTX compared to nRTX. The nRTX group exhibited no different diversity to the RTX group. Irrespective of the status of a previous renal transplantation, the urinary microbiome comprised > 210 different genera. An intraindividual change in microbiota diversity and richness was observed in one study patient during recovery from AKI.

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Updates on urinary tract infections in kidney transplantation

Cited by 56 publications

References 81 publications

Bacterial Urinary Tract Infection among Adult Renal Transplant Recipients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Bacterial Urinary Tract Infection among Adult Renal Transplant Recipients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Bacterial urinary tract infection among adult renal transplant recipients at St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia

The urinary microbiome shows different bacterial genera in renal transplant recipients and non-transplant patients at time of acute kidney injury – a pilot study

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