MP26-15 SYMPTOMATIC URINARY TRACT INFECTIONS IN RENAL TRANSPLANT PATIENTS AFTER CYSTOSCOPY FOR URETERAL STENT REMOVAL

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II1 Apr 2016MP26-15 SYMPTOMATIC URINARY TRACT INFECTIONS IN RENAL TRANSPLANT PATIENTS AFTER CYSTOSCOPY FOR URETERAL STENT REMOVAL Justin Gregg, Caroline Kang, Thomas Talbot, S. Duke Herrell, Roger Dmochowski, and Daniel Barocas Justin GreggJustin Gregg More articles by this author , Caroline KangCaroline Kang More articles by this author , Thomas TalbotThomas Talbot More articles by this author , S. Duke HerrellS. Duke Herrell More articles by this author , Roger DmochowskiRoger Dmochowski More articles by this author , and Daniel BarocasDaniel Barocas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2952AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Symptomatic urinary tract infection (UTI) is a known complication of cystoscopy with ureteral stent removal. However, little is known about the incidence and risk factors for post-cystoscopy UTI in renal transplant recipients, who likely represent a high-risk cohort. Our aim was to determine the infection rate following cystoscopy with stent removal in this population and identify opportunities for care improvement. METHODS We performed a retrospective cohort study of office cystoscopies with stent removal in renal transplant recipients performed at a single institution from April 2012 through May 2014. Symptomatic UTI was defined as having a single symptom (fever, urgency, frequency, dysuria, prostate tenderness or suprapubic tenderness) with a culture of 10^5 or more colony-forming units (CFU) per high-power field, or two symptoms with other characteristics such as a positive urinalysis or physician-diagnosed UTI within one month of procedure. Fisher's exact tests were completed to examine associations between patient characteristics (age, race, diabetes, smoking history, prednisone use, and deceased or living donor) and post-transplant outcomes (time to stent removal, readmission, non-genitourinary tract infection, delayed graft function, acute cellular rejection, and post-procedure urinary leak). Use of pre-procedural antibiotics in addition to daily prophylactic trimethoprim/sulfamethoxazole or dapsone was also evaluated. RESULTS A total of 324 patients underwent outpatient cystoscopy with stent removal. Mean age was 50.0 (SD 13.1) years, and 187 (57.7%) patients were male. Within this group, 200 (61.7%) patients underwent stent removal within four weeks of transplant. 165 (52.5%) patients received a pre-procedural oral fluroquinolone antibiotic dose prior to the procedure. Nine patients had symptomatic UTIs (2.8%), of which three infections (33.3%) were due to quinolone-resistant organisms. Univariate analyses revealed that female sex (P =0.04), was associated with symptomatic UTI. No other patient characteristic or post-operative outcome was associated with symptomatic UTI, including the use of peri-procedural antibiotics. CONCLUSIONS The incidence of symptomatic UTI after cystoscopy with ureteral stent removal in renal transplant recipients is less than three percent and comparable to post-cystoscopy UTI risk in the general population. Female sex is associated with symptomatic UTI. Further investigation is needed to identify groups most at risk for UTI and other complications. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e359 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Justin Gregg More articles by this author Caroline Kang More articles by this author Thomas Talbot More articles by this author S. Duke Herrell More articles by this author Roger Dmochowski More articles by this author Daniel Barocas More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...