The Impact of Urinary Tract Infections in Kidney Transplant Recipients: A Six-Year Single-Center Experience

Abstract

Background Urinary tract infections (UTIs) are the most common infections following kidney transplantation. Risk factors for UTIs in kidney transplant recipients include female gender, age, pre-transplant urinary tract abnormalities, diabetes, and recurrent UTIs. Infections of the bladder or urethra are termed lower UTIs, while those involving the kidneys or ureters are called upper UTIs. Methods We retrospectively screened our hospital information system to identify all patients who underwent kidney transplantation in the surgery department at King Abdulaziz Medical Center in Riyadh. A total of 553 records were ultimately included in the final analysis. Results A total of 553 patients were ultimately included in the analysis. More than half of the patients were males (62.4%), and 31.1% were aged between 45 and 60 years. Of these, 230 patients had a UTI, representing 41.59% of the sample. The most commonly reported causes were hypertensive nephrosclerosis (43.4%) and diabetic nephropathy (28.8%). The most frequently isolated causative agents were Escherichia coli (51.0%) and Klebsiella pneumoniae (21.8%). UTIs were significantly more prevalent among females, accounting for 73.6% of cases. Antibiotics were used in 86.5% of patients, with trimethoprim/sulfamethoxazole (65.8%) and ciprofloxacin (54.8%) being the most commonly prescribed. Conclusion About half of the patients in this study suffered from UTIs. E. coli and K. pneumoniae were the most commonly isolated organisms. Trimethoprim/sulfamethoxazole and ciprofloxacin were the most frequently prescribed antibiotics. A significant association was found between acquiring a UTI and being female (p < 0.001), as well as having pre-existing bladder dysfunction (p = 0.024).

Effect of increasing age and ureteral stent implantation on urinary tract infections after kidney transplantation – update of recent literature

“…The inconsistency in findings among studies may be due to variations in study populations, methodology, and most importantly age category definitions [ 25 ▪▪ ]. To sum up increasing age was confirmed as significant risk factor in six studies [ 3 ▪▪ , 11 ▪▪ , 22 ▪▪ , 23 ▪▪ , 25 ▪▪ , 28 ] comparing to three [ 24 , 29 , 30 ] studies failing to prove this association.…”

“…Another large meta-analysis from 2023 including 72 600 KTX patients confirmed these results, showing a 3% increase in the odds of experiencing a UTI with each year of age [ 23 ▪▪ ]. However, when looking at some newer studies, such as one from Al Tamimi et al in 2023, age categories including the age >60 were not associated with a higher risk of UTIs [ 24 ]. In contrast are findings form the Swiss Transplant Cohort Study [ 25 ▪▪ ] conducted in 2022, which analyzed one of the largest cohorts of nearly 3000 kidney transplant patients.…”