LONDON—Surveillance of urinary tract infections (UTI) in the first three months after a kidney transplant is a good option for improving quality of life of patients, according toa study published Aug. 19 in BMC Infectious Diseases.
UTIs have serious consequences and are one of the main complications after a kidney transplant, according to the researchers.
In understand this issue better, the researchers evaluated 52 patients with kidney transplantation for UTI at three to 145 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, 11 to 47 years old. The researchers used microscopic examinations, leukocyte esterase sticks, and urinary cultures every third day and weekly after hospitalization to track complications.
They found that UTI developed in 37 percent patients at three to 75 days after kidney transplantation. In addition, recurrent infection was seen in 13.4 percent of patients at days 17 to 65. UTI was more frequent in patients who received deceased grafts compared with live grafts (70 percent vs. 28 percent).
The researchers also reported that female patients were more susceptible to UTIs than male patients (50 percent vs. 36.35 percent). The five-year survival rate was 94.5 percent for all of the patients studied. Kidney graft exit update was 47/52 (90.2 percent), and there were no significant differences between graft rejection and UTI (p = 0.2518).
Isolated bacteria found were Escherichia coli (31.5 percent), Candida albicans (21.0 percent) and Enterococcus spp. (10.5 percent), followed by Pseudomonas aeruginosa, Klebsiella pneumoniae, Morganella morganii, Enterobacter cloacae and Micrococcus spp.
Secondary infections were seen in 36.8 percent of patients. Enterococcus spp. (57 percent), E. coli (28 percent) and Micrococcus spp. (14.2 percent).
Antibiotic resistance was 22 percent for ciprofloxacin and 33 percent for ampicillin. Therapeutic alternatives were aztreonam, trimethoprim-sulfamethoxazole, netilmicin and fosfomycin.
