Urinary tract infections in renal transplant recipients

Abstract

Urinary tract infection (UTI) is the most common infectious problem in kidney transplant recipients (KTR). It has been associated with risk factors inherent to the transplant and it could negatively affect clinical outcomes. The aim of this study was to describe demographic, clinical and microbiological characteristics of patients with UTI.We underwent a retrospective study reviewing the database of kidney transplants patients in a national reference center in Colombia. We included patients admitted for inpatient treatment related to urinary tract infection in the first year after transplantation.We describe clinical information from 65 patients, the mean age was 46 years, the most common comorbidity was hypertension (n=48/62, 77.4%) followed by diabetes mellitus (n=11/62, 17.7%); 77% (n=50/65) of the infections were diagnosed in the first 6 months after transplant and 70% (n=45/65) had pyelonephritis. Acute dysfunction of the graft was the most common complication in 59% (n=33/56) of cases. The most common etiological agent described was E. coli in 67% (n=37/55) of patients followed by Klebsiella pneumoniae (n=13/55). Bacteremia was present in 25% of cases. Infection with extended-spectrum betalactamases producing bacteria was present in 42% (n=18/42) of our isolations and multidrug resistance was documented in 39% (n=21/54) of isolates.Most UTI leading to hospitalization in KTR occur in the first six months. Pyelonephritis explains the majority of clinical diagnosis. The rate of blood stream infections and multidrug resistance bacteria is high, justifying an empiric broad-spectrum antibiotic treatment.