Impact of Urinary tract infections in short-term kidney graft outcome.
Clin Microbiol Infect. 2015 Jul 30;
Authors: Bodro M, Sanclemente G, Lipperheide I, Allali M, Marco F, Bosch J, Cofan F, Ricart MJ, Esforzado N, Oppenheimer F, Moreno A, Cervera C
Urinary tract infections (UTI) are frequent after renal transplantation but their impact in short-term graft outcome is not well established. All kidney transplantations performed between July 2003 and December 2010 were investigated to evaluate the impact of UTI on graft function at one year after transplantation. Of 867 patients who received a kidney transplant, 184 (21%) developed at least one episode of UTI, with a median of 18 days from transplantation. The prevalence of acute graft pyelonephritis (AGP) was 15%. The most frequent pathogens identified were E. coli, Klebsiella spp. and P. aeruginosa, 37% of which were considered multidrug-resistant (MDR) strains. Thirty-eight patients (4%) lost their graft, 225 (26%) had graft function impairment and the one-year mortality was 3%; however, no patient died as a consequence of a UTI. Surgical re-intervention and the development of at least one episode of AGP were independently associated with one-year graft function impairment. Moreover, the development of at least one episode of AGP was associated with graft loss at one year. Patients with AGP caused by a resistant strain presented with graft function impairment more frequently, although this did not reach statistical significance (53% vs 36%, p=0.07). Neither asymptomatic bacteriuria nor acute uncomplicated UTI were associated with graft function impairment in multivariate analysis. To conclude, UTI are frequent in kidney transplant recipients, especially in the early post-transplantation period. Although AGP was significantly associated with kidney graft function impairment and one-year post-transplantation graft loss, lower UTIs did not affect graft function.
PMID: 26235196 [PubMed - as supplied by publisher]