Actas de congresos
Urinary Tract Infection In Renal Transplant Recipients: Incidence, Risk Factors, And Impact On Graft Function
Registro en:
Transplantation Proceedings. Elsevier Usa, v. 46, n. 6, p. 1757 - 1759, 2014.
411345
10.1016/j.transproceed.2014.05.006
2-s2.0-84906090654
Autor
Camargo L.F.
Esteves A.B.A.
Ulisses L.R.S.
Rivelli G.G.
Mazzali M.
Institución
Resumen
Urinary tract infection (UTI) is the most common infection posttransplant. However, the risk factors for and the impact of UTIs remain controversial. The aim of this study was to identify the incidence of posttransplant UTIs in a series of renal transplant recipients from deceased donors. Secondary objectives were to identify: (1) the most frequent infectious agents; (2) risk factors related to donor; (3) risk factors related to recipients; and (4) impact of UTI on graft function. Patients and Methods. This was a retrospective analysis of medical records from renal transplant patients from January to December 2010. Local ethics committee approved the protocol. Results. The incidence of UTI in this series was 34.2%. Risk factors for UTI were older age, (independent of gender), biopsy-proven acute rejection episodes, and kidneys from deceased donors (United Network for Organ Sharing criteria). For female patients, the number of pretransplant pregnancies was an additional risk factor. Recurrent UTI was observed in 44% of patients from the UTI group. The most common infectious agents were Escherichia coli and Klebsiella pneumoniae, for both isolated and recurrent UTI. No difference in renal graft function or immunosuppressive therapy was observed between groups after the 1-year follow-up. Conclusions. In this series, older age, previous pregnancy, kidneys from expanded criteria donors, and biopsy-proven acute rejection episodes were risk factors for posttransplant UTI. Recurrence of UTI was observed in 44%, with no negative impact on graft function or survival. © 2014 by Elsevier Inc. All rights reserved. 46 6 1757 1759 Dantas, S.R., Kuboyama, R.H., Mazzali, M., Nosocomial infections in renal transplant patients: Risk factors and treatment implications associated with urinary tract and surgical site infection (2006) J Hosp Infect, 63, pp. 117-123 Fishman, J.A., Infection in solid-organ transplant recipients (2007) N Engl J Med, 357, pp. 2601-2614 Green, H., Rahamimov, R., Gafter, U., Antibiotic prophylaxis for urinary tract infections in renal transplant recipients: Systematic review and meta-analysis (2011) Transpl Infect Dis, 13, pp. 441-447 Yacoub, R., Akl, N.K., Urinary tract infections and asymptomatic bacteriuria in renal transplant recipients (2011) J Glob Infect Dis, 3, pp. 383-389 Lipsky, B.A., Urinary tract infections in men: Epidemiology, pathophysiology, diagnosis, and treatment (1989) Ann Intern Med, 110, pp. 138-150 Gavela Martínez, E., Pallardó Mateu, L.M., Sancho Calabuig, A., Delayed graft function after renal transplantation: An unresolved problem (2011) Transplant Proc, 43, pp. 2171-2173 Veroux, M., Giuffrida, G., Corona, D., Infective complications in renal allograft recipients: Epidemiology and outcome (2008) Transplant Proc, 40, pp. 1873-1876 Peleg, A.Y., Hooper, D.C., Hospital-acquired infections due to gram-negative bacteria (2010) N Engl J Med, 362, pp. 1804-1813 Di Cocco, P., Orlando, G., Mazzotta, C., Incidence of urinary tract infections caused by germs resistant to antibiotics commonly used after renal transplantation (2008) Transplant Proc, 40, pp. 1881-1884 Maraha, B., Bonten, H., Van Hooff, H., Infectious complications and antibiotic use in renal transplant recipients during a 1-year follow-up (2001) Clin Microbiol Infect, 7, pp. 619-625