Incidence of Urinary Tract Infections Caused by Germs Resistant to Antibiotics Commonly Used After Renal Transplantation

Cocco, Pierpaolo Di; Orlando, Giuseppe; Mazzotta, C.; Rizza, V.; D’Angelo, M.; Clemente, K.; Greco, Stefania; Famulari, A.; Pisani, F.

doi:10.1016/j.transproceed.2008.05.014

Cited by 41 publications

(20 citation statements)

References 14 publications

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“…The vast majority of UTIs occurred within the first month post-transplant, which is in agreement with our pilot study [3] and other reports in the literature [11,12,43]. Still, some other studies found that the highest incidence of UTIs was three to six month posttransplant [7][8][9][10].…”

Section: Discussionsupporting

confidence: 92%

“…As seen earlier, there was significant reduction in UTIs when two agents (norfloxacin and co-trimoxazole) were used as prophylaxis compared to when only one agent (norfloxacin) was used. Many recent reports have described the use of combinations as prophylaxis, including ciprofloxacin/co-trimoxazole [34][35][36], ceftriaxone/co-trimoxazole [19], and cefotaxime/co-trimoxazole [11]. Co-trimoxazole, which is present in all these combinations, has been considered a routine agent in the antibacterial prophylaxis in RTRs [29].…”

Section: Discussionmentioning

confidence: 99%

“…The onset of bacterial UTIs post-renal transplant has been reported by many studies, but as in the case of reported rates of infection, a consensus has not been reached. There are numerous reports stating that UTIs occur most commonly with the first three to six months [7][8][9][10] following transplant, while many others show that the highest incident for UTIs is one month post-transplant [3,11,12]. RTRs have multiple risk factors for acquiring UTIs post-renal transplant.…”

Section: Introductionmentioning

confidence: 99%

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Investigation of the effectiveness of antibacterial prophylaxis in renal transplant recipients

Alkatheri

Albekairy

Alharbi

et al. 2014

J Infect Dev Ctries

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Introduction: Bacterial urinary tract infections (UTIs) are very common complications in renal transplant recipients (RTRs). Methodology: This study is a follow-up to a previous investigation of post-renal transplant UTIs, which led to changes in the antibacterial agents used for prophylaxis and its duration. In this retrospective study of the medical records of 86 RTRs, the incidence, risk factors, causative bacteria, and duration prophylaxis were investigated. Results: The average age of the RTRs was 41.55 ± 14.06 years, and two-thirds of them were males. A total of 57.3% of the RTRs received cadaveric kidneys; the rest received kidneys from living related donors. The prescribed regimen (one month or three months of cotrimoxazole and norfloxacin) was completed by 75% of the RTRs. The incidence of UTIs in the RTRs who received this prophylaxis was 32.3%, which was significantly lower than the incidence with norfloxacin alone (56%). Female gender was found to be a risk factor for postrenal transplant UTIs. Escherichia coli was the most common pathogen (51.7%), followed by Klebsiella and Enterobacter (17.2% each). Most UTIs (86.2%) were detected within the first post-transplant month. Conclusions: There was no clear advantage to prescribing antibacterial prophylaxis for three months versus one month, as 86.2% of the UTIs occurred within the first month post-transplant regardless of prophylaxis duration. Using co-trimoxazole/norfloxacin compared to norfloxacin alone did positively affect patient outcome by reducing the incidence of UTIs. This study recommends antimicrobial sensitivity-guided modification of the antibacterial agents used for prophylaxis rather than extension of its duration.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Investigation of the effectiveness of antibacterial prophylaxis in renal transplant recipients

Alkatheri

Albekairy

Alharbi

et al. 2014

J Infect Dev Ctries

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“…Desde 1983, se describe cepas BLEE que afectan la respuesta a la antibioticoterapia (5) . La resistencia bacteriana actualmente representa un serio problema de salud global (6) . Un evento no menos importante está constituido por las infecciones recurrentes del tracto urinario, complicación a prevenir en esta clase de pacientes.…”

Section: Introductionunclassified

Infección del tracto urinario en receptores de trasplante renal

et al. 2017

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Introducción. La infección del tracto urinario (ITU) es común en receptores de trasplante renal (TR). La frecuencia de ITU depende de factores previos y posteriores al trasplante. Objetivos. Determinar la cronología de aparición de ITU sintomática, los microorganismos causantes y la incidencia de ITU resistente a antibióticos en receptores de TR. Diseño. Estudio retrospectivo. Lugar. Unidad de Trasplante Renal, Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Perú. Participantes. Pacientes sometidos a TR. Intervenciones. Se revisó la historia clínica de 304 pacientes sometidos a TR en el período 2002-2011, con seguimiento de hasta cuatro años por paciente. Se constató 215 episodios de ITU sintomática confirmada mediante urocultivo en 84 receptores. Principales medidas de resultados. Incidencia, cronología, determinación microbiológica/ susceptibilidad, resistencia bacteriana, factores de riesgo, estrategias diagnósticas, presencia o no de bacteriemia y manejo terapéutico. Resultados. En 50% de los 84 receptores el episodio inicial ocurrió durante los primeros tres meses, y en 39% se constató más de un episodio de ITU. Las bacterias representaron la etiología más frecuente (94%), siendo la Escherichia coli (77%) el uropatógeno prevalente, con tasa productora betalactamasa espectro extendido (BLEE) en 38%, seguida de Klebsiella pneumonie (11%) con BLEE 65%. En 12% de los 215 episodios de ITU el hemocultivo fue positivo. Entre los factores de riesgo se detectó luego del trasplante 19% receptores con anormalidades anatómicas del tracto urinario. Conclusiones. La ITU ocurrió tempranamente luego del trasplante y la Escherichia coli fue el microorganismo etiológico más frecuente. La resistencia antibiótica estuvo presente en 37% de los 215 episodios de ITU, representando un desafío contínuo a resolver en la práctica clínica.

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“…Conversely, the intestinal microbiota may influence solid organ transplant outcomes. The gut microbiota of organ transplant recipients is expected to undergo changes in its composition, as the majority of patients use antibiotics as prophylaxis or treatment of infections during initial hospitalization [12][13][14][15][16] . Since changes in the gut microbiota are associated with metabolic disarrangements in both the obese and the MS population, as described above [7][8][9] , similar effects might be observed in organ transplant recipients.…”

mentioning

confidence: 99%

Intestinal microbiota changes after solid organ transplant: a systematic review.

et al. 2018

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Incidence of Urinary Tract Infections Caused by Germs Resistant to Antibiotics Commonly Used After Renal Transplantation

Cited by 41 publications

References 14 publications

Investigation of the effectiveness of antibacterial prophylaxis in renal transplant recipients

Investigation of the effectiveness of antibacterial prophylaxis in renal transplant recipients

Infección del tracto urinario en receptores de trasplante renal

Intestinal microbiota changes after solid organ transplant: a systematic review.

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