30 June 2017 : Original article
Urinary Tract Infections After Kidney Transplantation: A Risk Factor Analysis of 417 PatientsLiselotte Ooms1ABCDEF*, Jan IJzermans1ACDE, Anne Voor in 't holt2CDE, Michiel Betjes3CE, Margreet Vos2ACDE, Turkan Terkivatan1ABCDE
Ann Transplant 2017; 22:402-408
BACKGROUND: The aim of this study was to evaluate the number of urinary tract infections (UTI) that occur after kidney transplantation (KT) and to identify possible risk factors for development of a UTI.
MATERIAL AND METHODS: We retrospectively analyzed all KTs performed between January 2012 and December 2013 in the Erasmus University Medical Center, Rotterdam. UTI was scored if: (1) a patient had a urine culture with no more than 2 species of microorganisms, (2) at least 1 of which was a bacterium of ≥10^5 CFU/mL, (3) which was treated with antibiotics, and (4) which occurred within 3 months after KT.
RESULTS: A total of 417 patients were transplanted from January 2012 until December 2013. A UTI developed in 115 (28%), after a median of 13 days from transplantation (range: 3–82 days). The most common causative agent was Escherichia coli, followed by Enterococcus faecalis, Enterococcus faecium, and Klebsiella pneumoniae. The variables that were independently related to a UTI were female gender (OR 3.58, 95%CI 2.16–5.91), recipients age >60 y (OR 2.12, 95%CI 1.28–3.48), percutaneous nephrostomy placements (OR 6.29, 95%CI 3.35–11.85), and surgical re-interventions (OR 2.12, 95%CI 1.04–4.32). Mean glomerular filtration rate was significantly lower in the group of patients with a UTI at 3, 6, 9, and 12 months postoperatively compared to those patients who did not have a UTI.
CONCLUSIONS: We conclude that a UTI after KT is a common problem. We identified independent risk factors for the development of a UTI. UTI is associated with a GFR decrease postoperatively.
Keywords: Incidence, Kidney Transplantation, Risk Factors, Urinary Tract Infections
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