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BMC Infect Dis ; 10: 245, 2010 Aug 19.
Article in English | MEDLINE | ID: mdl-20723254

ABSTRACT

BACKGROUND: Urinary tract infection (UTI) remains one of the main complications after kidney transplantation and it has serious consequences. METHODS: Fifty-two patients with kidney transplantation were evaluated for UTI at 3-145 days (mean 40.0 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, aged 11-47 years. Microscopic examinations, leukocyte esterase stick, and urinary culture were performed every third day and weekly after hospitalization. A positive culture was consider when patients presented bacterial counts up to 105 counts. RESULTS: UTI developed in 19/52 (37%) patients at 3-75 days (mean 19.5 days after transplantation. Recurrent infection was observed in 7/52 (13.4%) patients at days 17-65. UTI was more frequent in patients who received deceased grafts compared with live grafts (7/10, 70% vs. 12/42, 28%; p < 0.007). Female patients were more susceptible than male (11/22, 50% vs. 8/22, 36.35%; p < 0.042). Five-year survival rate was 94.5% (49/52 patients). Kidney Graft exit update is 47/52 (90.2%), and there were no significant differences between graft rejection and UTI (p = 0.2518). Isolated bacteria were Escherichia coli (31.5%), Candida albicans (21.0%) and Enterococcus spp. (10.5%), followed by Pseudomonas aeruginosa, Klebsiella pneumoniae, Morganella morganii, Enterobacter cloacae and Micrococcus spp. Secondary infections were produced by (7/19, 36.8%). Enterococcus spp. (57%), E. coli (28%) and Micrococcus spp. (14.2%). Antibiotic resistance was 22% for ciprofloxacin and 33% for ampicillin. Therapeutic alternatives were aztreonam, trimethoprim-sulfamethoxazole, netilmicin and fosfomycin. CONCLUSIONS: Surveillance of UTI for the first 3 months is a good option for improving quality of life of kidney transplantation patients and the exit of graft function especially for female patients and those receiving deceased grafts. Antibiograms provided a good therapeutic alternative to patients who presented with UTIs after receiving a kidney allograft.


Subject(s)
Kidney Transplantation/adverse effects , Postoperative Complications/epidemiology , Urinary Tract Infections/epidemiology , Adolescent , Adult , Bacteria/classification , Bacteria/isolation & purification , Bacterial Infections/epidemiology , Bacterial Infections/microbiology , Bacterial Infections/mortality , Candida albicans/isolation & purification , Candidiasis/epidemiology , Candidiasis/microbiology , Candidiasis/mortality , Child , Female , Follow-Up Studies , Humans , Immunocompromised Host , Male , Middle Aged , Postoperative Complications/microbiology , Postoperative Complications/mortality , Prevalence , Prospective Studies , Survival Analysis , Urinary Tract Infections/microbiology , Urinary Tract Infections/mortality , Young Adult
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