Prospective study of urinary tract infection surveillance after kidney transplantation

• Main Authors: Rivera-Sanchez Roberto, Delgado-Ochoa Dolores, Flores-Paz Rocio R, García-Jiménez Elvia E, Espinosa-Hernández Ramon, Bazan-Borges Andres A, Arriaga-Alba Myriam
• Format: Article
• Language: English
• Published: BMC 2010-08-01
• Series: BMC Infectious Diseases
• Online Access: http://www.biomedcentral.com/1471-2334/10/245

<p>Abstract</p> <p>Background</p> <p>Urinary tract infection (UTI) remains one of the main complications after kidney transplantation and it has serious consequences.</p> <p>Methods</p> <p>Fifty-two patients with kidney transplantation were evaluated for UTI at 3-145 days (mean 40.0 days) after surgery.. Forty-two received a graft from a live donor and 10 from a deceased donor. There were 22 female and 30 male patients, aged 11-47 years. Microscopic examinations, leukocyte esterase stick, and urinary culture were performed every third day and weekly after hospitalization. A positive culture was consider when patients presented bacterial counts up to 10⁵ counts.</p> <p>Results</p> <p>UTI developed in 19/52 (37%) patients at 3-75 days (mean 19.5 days after transplantation. Recurrent infection was observed in 7/52 (13.4%) patients at days 17-65. UTI was more frequent in patients who received deceased grafts compared with live grafts (7/10, 70% <it>vs</it>. 12/42, 28%; p < 0.007). Female patients were more susceptible than male (11/22, 50% <it>vs</it>. 8/22, 36.35%; p < 0.042). Five-year survival rate was 94.5% (49/52 patients). Kidney Graft exit update is 47/52 (90.2%), and there were no significant differences between graft rejection and UTI (p = 0.2518). Isolated bacteria were <it>Escherichia coli </it>(31.5%), <it>Candida albicans </it>(21.0%) and <it>Enterococcus </it>spp. (10.5%), followed by <it>Pseudomonas aeruginosa, Klebsiella pneumoniae, Morganella </it><it>morganii, Enterobacter cloacae </it>and <it>Micrococcus </it>spp. Secondary infections were produced by (7/19, 36.8%). <it>Enterococcus </it>spp. (57%), <it>E. coli </it>(28%) and <it>Micrococcus </it>spp. (14.2%). Antibiotic resistance was 22% for ciprofloxacin and 33% for ampicillin. Therapeutic alternatives were aztreonam, trimethoprim-sulfamethoxazole, netilmicin and fosfomycin.</p> <p>Conclusions</p> <p>Surveillance of UTI for the first 3 months is a good option for improving quality of life of kidney transplantation patients and the exit of graft function especially for female patients and those receiving deceased grafts. Antibiograms provided a good therapeutic alternative to patients who presented with UTIs after receiving a kidney allograft.</p>