Urinary Tract Infections in Renal Transplant Recipients

Senger, SS; Arslan, Hande; Azap, Özlem Kurt; Timurkaynak, Funda; Çağır, Ünal; Haberal, Mehmet

doi:10.1016/j.transproceed.2007.02.060

Cited by 58 publications

(48 citation statements)

References 7 publications

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“…2,7,[11][12][13][14][16][17]19 We also observed that Escherichia coli (22.7%) and Klebsiella pneumoniae (9.2%) were the most common microbial agents. We found a rate of 5.8% for Acinetobacter baumannii, which reportedly shows antibiotic resistance and causes hospital infection outbreaks.…”

Section: Discussionmentioning

confidence: 60%

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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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Section: Discussionmentioning

confidence: 60%

“…2,7,14 Studies have reported UTI rates of 35% to 79% after transplant. 2,7,12,[14][15][16][17] Urinary tract infections are the cause of infectious complications and hospital admissions and 70% of deaths associated with sepsis (48%) and pneumonia (22%). 18 During the past 25 years, however, infection-related deaths have been decreasing.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Yabanoğlu

Alışkan²,

Çalışkan³

et al. 2015

Exp Clin Transplant

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“…La Escherichia coli (77%) (tabla 1) fue el uropatógeno prevalente, seguido de la Klebsiella pneumoniae (11%), Pseudomonas aeruginosa (3%) y Enterococcus faecium (3%) (3,10,12,42) , prevalencia bacteriana no coincidente con el mapa microbiológico de nuestras infecciones intrahospitalarias (año 2011), que señalaron en orden de frecuencia la Pseudomona aeruginosa 17%, Escherichia coli 16%, estafilococos coagulasa negativo 15% y Klebsiella pneumoniae 12%, como patógenos predominantes (41) .…”

Section: Discussionunclassified

Infección del tracto urinario en receptores de trasplante renal

et al. 2017

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Introducción. La infección del tracto urinario (ITU) es común en receptores de trasplante renal (TR). La frecuencia de ITU depende de factores previos y posteriores al trasplante. Objetivos. Determinar la cronología de aparición de ITU sintomática, los microorganismos causantes y la incidencia de ITU resistente a antibióticos en receptores de TR. Diseño. Estudio retrospectivo. Lugar. Unidad de Trasplante Renal, Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Perú. Participantes. Pacientes sometidos a TR. Intervenciones. Se revisó la historia clínica de 304 pacientes sometidos a TR en el período 2002-2011, con seguimiento de hasta cuatro años por paciente. Se constató 215 episodios de ITU sintomática confirmada mediante urocultivo en 84 receptores. Principales medidas de resultados. Incidencia, cronología, determinación microbiológica/ susceptibilidad, resistencia bacteriana, factores de riesgo, estrategias diagnósticas, presencia o no de bacteriemia y manejo terapéutico. Resultados. En 50% de los 84 receptores el episodio inicial ocurrió durante los primeros tres meses, y en 39% se constató más de un episodio de ITU. Las bacterias representaron la etiología más frecuente (94%), siendo la Escherichia coli (77%) el uropatógeno prevalente, con tasa productora betalactamasa espectro extendido (BLEE) en 38%, seguida de Klebsiella pneumonie (11%) con BLEE 65%. En 12% de los 215 episodios de ITU el hemocultivo fue positivo. Entre los factores de riesgo se detectó luego del trasplante 19% receptores con anormalidades anatómicas del tracto urinario. Conclusiones. La ITU ocurrió tempranamente luego del trasplante y la Escherichia coli fue el microorganismo etiológico más frecuente. La resistencia antibiótica estuvo presente en 37% de los 215 episodios de ITU, representando un desafío contínuo a resolver en la práctica clínica.

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“…As seen earlier, there was significant reduction in UTIs when two agents (norfloxacin and co-trimoxazole) were used as prophylaxis compared to when only one agent (norfloxacin) was used. Many recent reports have described the use of combinations as prophylaxis, including ciprofloxacin/co-trimoxazole [34][35][36], ceftriaxone/co-trimoxazole [19], and cefotaxime/co-trimoxazole [11]. Co-trimoxazole, which is present in all these combinations, has been considered a routine agent in the antibacterial prophylaxis in RTRs [29].…”

Section: Discussionmentioning

confidence: 99%

Investigation of the effectiveness of antibacterial prophylaxis in renal transplant recipients

Alkatheri

Albekairy

Alharbi

et al. 2014

J Infect Dev Ctries

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Introduction: Bacterial urinary tract infections (UTIs) are very common complications in renal transplant recipients (RTRs). Methodology: This study is a follow-up to a previous investigation of post-renal transplant UTIs, which led to changes in the antibacterial agents used for prophylaxis and its duration. In this retrospective study of the medical records of 86 RTRs, the incidence, risk factors, causative bacteria, and duration prophylaxis were investigated. Results: The average age of the RTRs was 41.55 ± 14.06 years, and two-thirds of them were males. A total of 57.3% of the RTRs received cadaveric kidneys; the rest received kidneys from living related donors. The prescribed regimen (one month or three months of cotrimoxazole and norfloxacin) was completed by 75% of the RTRs. The incidence of UTIs in the RTRs who received this prophylaxis was 32.3%, which was significantly lower than the incidence with norfloxacin alone (56%). Female gender was found to be a risk factor for postrenal transplant UTIs. Escherichia coli was the most common pathogen (51.7%), followed by Klebsiella and Enterobacter (17.2% each). Most UTIs (86.2%) were detected within the first post-transplant month. Conclusions: There was no clear advantage to prescribing antibacterial prophylaxis for three months versus one month, as 86.2% of the UTIs occurred within the first month post-transplant regardless of prophylaxis duration. Using co-trimoxazole/norfloxacin compared to norfloxacin alone did positively affect patient outcome by reducing the incidence of UTIs. This study recommends antimicrobial sensitivity-guided modification of the antibacterial agents used for prophylaxis rather than extension of its duration.

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Urinary Tract Infections in Renal Transplant Recipients

Cited by 58 publications

References 7 publications

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Infección del tracto urinario en receptores de trasplante renal

Investigation of the effectiveness of antibacterial prophylaxis in renal transplant recipients

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