Abstract
(1) Background: Urinary tract infections (UTI) are the most common infections after kidney transplantation. Given the risk of urosepsis and the potential threat to the graft, the threshold for treating UTI and asymptomatic bacteriuria with broad spectrum antibiotics is low. Historically fluoroquinolones were prescription favorites for patients that underwent kidney transplantation (KT). After the recent recommendation to avoid them in these patients, however, alternative treatment strategies need to be investigated (2) Methods: We retrospectively analyzed the charts of 207 consecutive adult kidney transplantations that were performed at the department of General, Visceral and Transplantation Surgery of the University Hospital of Tuebingen between January 2015 and August 2020. All charts were screened for the diagnosis and treatment of asymptomatic bacteriuria (ASB) and urinary tract infections (UTI) and the patients’ clinical characteristics and outcomes were evaluated. (3) Results: Of the 207 patients, 68 patients suffered from urinary tract infections. Patients who developed UTI had worse graft function at discharge (p = 0.024) and at the 12 months follow-up (p < 0.001). The most commonly prescribed antibiotics were Ciprofloxacin and Piperacillin/Tazobactam. To both, bacterial resistance was more common in the study cohort than in the control group. (4) Conclusions: Urinary tract infections appear to be linked to worse graft functions. Thus, prevention and treatment should be accompanied by antibiotic stewardship teams.
Highlights
Urinary tract infections (UTI) are the most common infection in the early postoperative phase after kidney transplantation (KT) [1,2]
(4) Conclusions: Urinary tract infections appear to be linked to worse graft functions
For the purpose of this study we evaluated our antibiotic prescription practice during the first 30 days after kidney transplant, the incidence of asymptomatic bacteriuria (ASB) and UTIs and compared the antibiotic susceptibility of the isolated urinary tract bacteria from KT recipients to those isolated from the local population based on data provided by our hygiene department
Summary
Urinary tract infections (UTI) are the most common infection in the early postoperative phase after kidney transplantation (KT) [1,2]. UTIs are defined as the growth of 105 colony forming units on a proper urine sample (i.e., morning urine, puncture urine or from sterile single catheterization) in the presence of symptoms such as dysuria, urinary frequency or localized pain [6]. In contrast to UTIs asymptomatic bacteriuria (ASB) is defined as the presence of ≥105 colony-forming units of bacteria in the absence of symptoms [7]. The incidence of UTI is assumed to be lower in living donation kidney transplantation since these patients often have shorter waiting time, higher volume urine output prior to and during transplantation as well as early onset graft function [16]
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