Infectious complications after kidney transplantation: current epidemiology and associated risk factors

Alangaden, George; Thyagarajan, Rama; Gruber, Scott A.; Morawski, Katherina; Garnick, James; El-Amm, Jose M.; West, Michael O.; Sillix, Dale H.; Chandrasekar, Pranatharthi H.; Haririan, Abdolreza

doi:10.1111/j.1399-0012.2006.00519.x

Cited by 378 publications

(321 citation statements)

References 33 publications

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“…Comparatively, this result indicates that the incidence of infectious episodes in renal transplant recipients among us is equivalent to that observed in other countries of different regions in the world. In 2006, Alangaden et al 8 studied 127 renal transplanted patients at a North-American center and reported infectious complications in 51% of those recipients.…”

Section: Discussionmentioning

confidence: 99%

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Incidência e fatores de risco para complicações infecciosas no primeiro ano após o transplante renal

Sousa¹,

Galante²,

Barbosa

et al. 2010

J. Bras. Nefrol.

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Introduction: Infectious complications significantly increase morbidity and mortality after renal transplantation. The immunosuppression used is the main risk factor and relates directly to the incidence and severity of infectious events. Methods: This is a retrospective cohort study, which assessed the incidence of infections and their risk factors among 1,676 kidney transplant recipients during the first year of follow-up. Results: Infectious events were observed in 821 (49%) patients. The mean number of infectious episodes among patients with at least one episode was 2.3 (1 -12). The most prevalent infectious complications were as follows: urinary tract infection (31.3%); cytomegalovirus infection (12%); surgical wound infection (10.3%); herpes virus infection (9.1%); pulmonary infection (5.2%); and bloodstream infection (4.3%). Cold ischemia time and the use of deceased donor grafts were important risk factors for infectious episodes. Conclusions: Infections are highly prevalent in the first year following transplantation. The main infectious complication was urinary tract infection.

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Section: Discussionmentioning

confidence: 99%

“…In 2006, Alangaden et al 8 reported a 7% incidence of infectious episodes in the surgical wound in a cohort of 127 renal transplanted patients. This result is also similar to that obtained in 2009 by a Spanish group reporting a 7.9% incidence of that same complication.…”

Section: Factors F O R the Development O F I N F E C T I O N After Trmentioning

confidence: 99%

Incidência e fatores de risco para complicações infecciosas no primeiro ano após o transplante renal

Sousa¹,

Galante²,

Barbosa

et al. 2010

J. Bras. Nefrol.

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“…Especially in the setting of renal transplantation, asymptomatic bacteriuria or symptomatic forms such as cystitis (Cys) and pyelonephritis (PN) account for approximately 47% of infectious complications (1) and up to 60% of bacteremias (2). The development of UTIs depends on anatomical factors, the integrity of host defense mechanisms, and the virulence of the infecting organisms (3).…”

mentioning

confidence: 99%

The Role of Host Factors and Bacterial Virulence Genes in the Development of Pyelonephritis Caused by Escherichia coli in Renal Transplant Recipients

Siliano

Rocha

Medina-Pestana

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives: The aim of this study was to determine the role of host factors and bacterial virulence genes in the development of pyelonephritis caused by Escherichia coli in renal transplant (Tx) recipients.Design, setting, participants, & measurements: A total of 328 E. coli isolates from cases of cystitis (Cys; n ‫؍‬ 239) or pyelonephritis (PN; n ‫؍‬ 89), with 169 from renal Tx recipients, were subjected to molecular analyses to identify P-fimbria subunits (PapC, PapG II, and PapGIII), G-and M-fimbriae, and aerobactin. The presence of antibiotic resistance was also determined. Parameters such as gender, age, immunosuppression regimens, causes of ESRD, kidney donor, intraoperative anastomosis, use of double J stent, trimethoprim/sulfamethoxazole (TMP/SMZ) prophylaxis, and time after Tx were evaluated.Results: A multivariate analysis showed a significant association between PN and renal Tx. In renal Tx recipients, the risk of occurrence of PN was significantly higher among males and for those no longer receiving TMP/SMZ prophylaxis. E. coli strains isolated from PN presented a lower prevalence of papGIII and lower rates of resistance to pipemidic acid. Although papGII was more prevalent in PN than in Cys, it was not independently associated with PN.Conclusions: These findings suggested that renal Tx increases the risk for PN, and the male sex represented a host factor independently associated with risk, whereas the prophylaxis with TMP/SMZ was protective. The lack of papGIII and low resistance to first-generation quinolones were bacterial-independent risk factors for PN in Tx.

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“…In this case, prophylaxis can be considered for a longer time, 20 since there is a description that the disease may occur later in those who are no longer using prophylactic medication. 21 It is important to note that although urinary infection is the most common in the renal transplant, 22 pulmonary infection is the main cause of sepsis and hospitalization in the ICU. 8,10,23,24 Traditionally, a greater number of infections are expected in the first 6 months of transplantation, a period in which immunosuppression is more intense.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with hospital mortality in renal transplant patients admitted to the intensive care unit with acute respiratory failure

Silva

Freitas

Bafi

et al. 2017

Jornal Brasileiro De Nefrologia

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Infectious complications after kidney transplantation: current epidemiology and associated risk factors

Abstract: This study suggests that the use of newer immunosuppressive agents in recent years is associated with some changes in the epidemiology of post-transplant infections. Enterococci have become the predominant uropathogen. Invasive fungal infections, although rare, are often fatal.

Cited by 378 publications

References 33 publications

Incidência e fatores de risco para complicações infecciosas no primeiro ano após o transplante renal

Incidência e fatores de risco para complicações infecciosas no primeiro ano após o transplante renal

The Role of Host Factors and Bacterial Virulence Genes in the Development of Pyelonephritis Caused by Escherichia coli in Renal Transplant Recipients

Factors associated with hospital mortality in renal transplant patients admitted to the intensive care unit with acute respiratory failure

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