Clinical characteristics and pathogens of recurrent urinary tract infection after renal transplantation

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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 regression model. 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. Key words: Kidney transplantation; Genitourinary system infection; Antibiotic