Clinical characteristics and pathogens of recurrent urinary tract infection after renal transplantation / 中华器官移植杂志

Objective To investigate the clinical characteristics and the pathogens of recurrent urinary tract infection (RUTI) after renal transplantation.Methods The data of adult recipients with UTI from November 2011 to December 2016 were retrospectively analyzed.The recipients were divided into single UTI (SUTI) group and RUTI group.The clinical characteristics and pathogens were analyzed,and the independent risk factors of RUTI were analyzed using logistic regressionmodel.Results Fifty-three cases were selected,including 29 cases of SUTI and 24 cases of RUTI.The positive rate of blood culture (55％ vs.25％,P =0.042) and the concentration of FK506 in the peri-infection period (11.0 + 3.4 ng/mL vs.8.6 + 3.2 ng/mL,P =0.024) in the RUTI group were significantly higher than that those in the SUTI group at the first UTI.The increased concentration of FK506 in the peri-infection period at the first UTI was an independent risk factor for RUTI (β:0.282,95％ CI:1.026-1.713,P＜0.05).There were 86 infection events in 53 patients,and pathogenic microorganisms were cultured in blood culture and urine culture for 86 times.The positive frequency of culture in the RUTI group was higher than that in the SUTI group,but not significantly.The most common pathogenic microorganisms included Escherichia coli (17 times),pseudomonas aeruginosa (16 times),and Enterococcus (16 times).Conclusion Reduction of the FK506 concentration during the peri-infection period at the first UTI is the key to prevent RUTI after renal transplantation.The empirical antibiotics for RUTI should be sensitive for Escherichia coli (ESBL +)and pseudomonas aeruginosa.

CT and MR Findings of Genitourinary Tuberculosis

Genitourinary tuberculosis is a disease spread hematogenously from a small tuberculous abscess of the lung. The renal cortex is initially involved, and multiple granulomas form. Ultimately the cortex may cavitate and communicate with the collecting system, allowing downward extension of the infection and subsequent focal caliectasis with infundibular stenosis, ureteral fibrosis, and calcifications of urinary tract organs. The female genitourinary organ is also infected by the hematogenous spread of tuberculosis, the most common lesion be-ing hydrosalpynx with salpingitis. The clinical and radiologic features of genitourinary tuberculosis may mimic other acute abdominal diseases, and the diagnosis of tuberculosis remains difficult. This report describes the ways in which computed tomography and magnetic resonance imaging are valuable aids in the recognition and diagnosis of genitourinary tuberculosis.

Pyourachus: A Case Report

Pyourachus is an infection of urachal cyst which is one of congenital urachal anormalies. It should bedifferentiated from urachal tumor in adult, and abdominal desmoplastic round cell tumor, non-Hodgkin's lymphoma,and intra-abdominal desmoid tumor in children. The CT findings of pyourachus are characteristic to provide anaccurate preoperative diagnosis. The authors encountered a case of pyourachus in a 58-year-old male and report thecharacteristic CT findings. A large hypodense spherical mass with irregular thickened wall was present in themidline of the lower abdomen under the rectus abdominalis muscle extending from the dome of the urinary bladder tothe level of the umbilicus.