Urinary Tract Infections in the Early Posttransplant Period After Simultaneous Pancreas–Kidney Transplantation

Kawecki, D.; Kwiatkowski, A.; Michalak, Grzegorz; Sawicka-Grzelak, A.; Młynarczyk, A; Sokół-Leszczyńska, Beata; Lazinska, B.; Dzieciątkowski, Tomasz; Przybylski, Maciej; Czerwiński, Jarosław; Lisik, Wojciech; Bieniasz, M.; Wszoła, Michał; Domagała, Piotr; Rowińskí, W; Durlik, M.; Łuczak, M.; Chmura, A.; Młynarczyk, G.

doi:10.1016/j.transproceed.2009.07.065

Cited by 10 publications

(3 citation statements)

References 7 publications

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“…As previous studies have shown , our results confirm that bacterial UTI is a frequent complication in renal (7.3%) and kidney–pancreas transplants (4.9%). The frequency of bacterial UTI is around 2% in liver and heart transplants and <1% in lung transplants.…”

Section: Discussionsupporting

confidence: 91%

“…Bacterial urinary tract infection (UTI) is a well known complication in renal and kidney–pancreas transplant recipients . Classic studies have shown that the first year following transplantation is the period of highest risk, that Escherichia coli is the most frequent etiology, and that cotrimoxazole as prophylaxis against opportunistic infections reduces their incidence without producing a significant colonization of resistant gram‐negative bacilli .…”

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confidence: 99%

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Bacterial urinary tract infection after solid organ transplantation in the RESITRA cohort

Vidal

Torre‐Cisneros

Blanes

et al. 2012

Transplant Infectious Dis

160

113

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Background Urinary tract infection (UTI) is the most common infection in renal transplant patients, but it is necessary to determine the risk factors for bacterial UTI in recipients of other solid organ transplants (SOTs), as well as changes in etiology, clinical presentation, and prognosis. Methods In total, 4388 SOT recipients were monitored in 16 transplant centers belonging to the Spanish Network for Research on Infection in Transplantation (RESITRA). The frequency and characteristics of bacterial UTI in transplant patients were obtained prospectively from the cohort (September 2003 to February 2005). Results A total of 192 patients (4.4%) presented 249 episodes of bacterial UTI (0.23 episodes per 1000 transplantation days); 156 patients were kidney or kidney–pancreas transplant recipients, and 36 patients were liver, heart, and lung transplant recipients. The highest frequency was observed in renal transplants (7.3%). High frequency of cystitis versus pyelonephritis without related mortality was observed in both groups. The most frequent etiology was Escherichia coli (57.8%), with 25.7% producing extended‐spectrum β‐lactamase (ESBL). In all transplants but renal, most cases occurred in the first month after transplantation. Cases were uniformly distributed during the first 6 months after transplantation in renal recipients. Age (odds ratio [OR] per decade 1.1, 95% confidence interval [CI] 1.02–1.17), female gender (OR 1.74, 95% CI 1.42–2.13), and the need for immediate post‐transplant dialysis (OR 1.63, 95% CI 1.29–2.05) were independent variables associated with bacterial UTI in renal and kidney–pancreas recipients. The independent risk factors identified in non‐renal transplants were age (OR per decade 1.79, 95% CI 1.09–3.48), female gender (OR 1.7, 95% CI 1.43–2.49), and diabetes (OR 1.02, 95% CI 1.001–1.040). Conclusions UTI was frequent in renal transplants, but also not unusual in non‐renal transplants. Because E. coli continues to be the most frequent etiology, the emergence of ESBL‐producing strains has been identified as a new problem. In both populations, most cases were cystitis without related mortality. Although the first month after transplantation was a risk period in all transplants, cases were uniformly distributed during the first 6 months in renal transplants. Age and female gender were identified as risk factors for UTI in both populations. Other particular risk factors were the need for immediate post‐transplant dialysis in renal transplants and diabetes in non‐renal transplants.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Bacterial urinary tract infection after solid organ transplantation in the RESITRA cohort

Vidal

Torre‐Cisneros

Blanes

et al. 2012

Transplant Infectious Dis

160

113

View full text Add to dashboard Cite

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“…Other risk factors in SOT recipients are prolonged hospitalization [49], urologic manipulation, use of ureteral stents and urethral catheterization, which is common in KT [5,50], duration of antibiotic treatment and perioperative prophylaxis, specifically in KT [51].…”

Section: Enterobacteriaceae Infections After Sot?mentioning

confidence: 99%

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Aguado

Silva

Fernández‐Ruiz

et al. 2018

Transplantation Reviews

124

139

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Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection.

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Perioperative Infections after Organ Transplantation

Kaul

Green

2014

Textbook of Organ Transplantation

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Urinary Tract Infections in the Early Posttransplant Period After Simultaneous Pancreas–Kidney Transplantation

Cited by 10 publications

References 7 publications

Bacterial urinary tract infection after solid organ transplantation in the RESITRA cohort

Bacterial urinary tract infection after solid organ transplantation in the RESITRA cohort

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Perioperative Infections after Organ Transplantation

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