Urine Bacteriology in Post-Kidney Transplant Patients with Double-J Stents

Abu, Sherifatu; Igbokwe, Martin; Olatise, OO; Okafor, Maryann; A, So; Adetunbi, AR

doi:10.30442/ahr.0704-04-146

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…E. coli was the most common organism cultured in both urine and stent accounting for 38% and 36% respectively [31]. Gram-negative microorganisms are the most common (around 50-90%) cause of UTI post kidney transplantation, with E. coli being the most commonly occurring microorganism found in urine cultures, and this is similar to findings in the general population [21].…”

Section: Discussionsupporting

confidence: 58%

Bacterial Colonization in Double J Stent and Bacteriuria in Post-Renal Transplant Patients

Abu¹,

Asaolu²,

Igbokwe³

et al. 2022

Cureus

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Background and objectiveUrinary tract infections (UTI) in kidney transplant recipients can cause significant morbidity and negatively impact both, graft and patient survival. Ureteric stenting in renal transplantation is aimed at reducing the risks of complications like ureteric leak and stenosis. Ureteric stents are not without their potential complications which may include UTI. We aimed to compare urine bacteriology and bacterial colonization of DJ stent following kidney transplantation, and to establish antimicrobial susceptibility to guide the choice of empirical antibiotics in the event of UTI in post-transplant patients with DJ stent. Materials and methodsThis was a prospective study carried out over a year period (February 2020 to January 2021). Eighty postrenal transplant patients with indwelling ureteral stents were recruited for the study. An early morning midstream urine sample was taken for analysis from consenting patients that met the inclusion criteria. All stents were removed via rigid cystoscopy and the distal end of the stent (4cm) was cut off and put in a sterile bottle for microbiological analysis. Sensitivity and resistance were tested against a panel of 19 antibiotics on all microbial isolates. Results were considered statistically significant when p < 0.05. ResultsThe mean age of the patients was 47.9+ 12.1 years. Male patients were 60 (75%) while 20 (25%) were females. Fifty-one (52%) patients had hypertension while 25 (26%) had diabetes mellitus. Hypertension and diabetes were noted in 20 (21%) patients while only one patient (1%) had HCV. Prior to renal transplantation, patients had negative urine cultures. The majority of the patients (76, 95%) had their stent retrieved after 4 weeks, 2 (2.5%) of them had stents retrieved after 2 weeks, and 2 (2.5%) had stents retrieved after 8 weeks. There was a significant association between the duration of stent and stent colonization (p=0.031).No organism was cultured in both the urine and stent in 13 (14.4%) patients. Nine (10%) had positive stent culture with a negative urine culture while 5 (5.6%) had positive urine culture with a negative stent culture. The same organism was noted in both urine and stent in 58 (64.4%) of patients while different organisms were cultured in 5 (5.6%) of the patients. Escherichia coli was the most common organism cultured in the urine of 38 (65.5%) patients and 36 (58.1%) stents, respectively.The sensitivity pattern shows that the organisms were more susceptible to nitrofurantoin and gentamicin, and resistant to tetracycline and ceftriaxone. Tigecycline showed good susceptibility and poor resistance. ConclusionThis study shows that stent colonization was slightly higher than urine bacteriology, with both demonstrating similar microbiological patterns. Selection of the initial empiric treatment should be based on local epidemiological data. Initial therapy should be de-escalated to the most narrow-spectrum antibiotics to complete the course of therapy once culture and sensitivity data is available. Antibiotics stew...

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Section: Discussionsupporting

confidence: 58%

Bacterial Colonization in Double J Stent and Bacteriuria in Post-Renal Transplant Patients

Abu¹,

Asaolu²,

Igbokwe³

et al. 2022

Cureus

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“…Ureteroneocystostomy using the Modified Lich-Gregoir technique over a double-J stent was performed in all but 5 patients who had uretero-ureterostomies and the stents removed following 4 weeks of surgery as per unit protocol [17,18]. Delayed removal of double-J stents beyond 4 weeks was encountered in 12 patients with complications like urine leaks in the post-operative period.…”

Section: Resultsmentioning

confidence: 99%

Kidney Transplantation in Nigeria: A Single Centre’s Early Surgical Experience and Outcomes

Igbokwe,

Olatise,

Olatise

et al. 2023

OBM Transplant

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With the rise in the population of patients with End-stage Renal Disease (ESRD) in Nigeria, there is an increased demand for Renal Replacement Therapy (RRT) including kidney transplantation (KT). We present our initial surgical experience and early outcomes with KT at a Nigerian transplant center over 2 years. A 2-year retrospective review of patients who underwent KT was done. Data of both kidney donors and recipients were recorded in designed proformas. Extracted information included demographic characteristics, side of open donor nephrectomy (ODN), recipient anatomy, surgical techniques and postoperative outcomes. Data were analyzed using SPSS version 21. A total of 210 patients had KT during the period under review<em>. </em>Donors had an age range of 19 to 53 years with a mean of 30.8 3 ± 8.43 years while recipients aged between 9 and 73 years with a mean of 45.97 ± 13.71 years. There were 190 (90.5%) male and 20 (9.5%) female donors. One hundred fifty-four recipients were males (73.3%) and 56 (26.7%) were females. Left ODN was performed in 152 (72.4%) of cases and the commonest indication for right ODN was multiple left renal arteries. The allograft was placed in the right iliac fossa in 187 (89.0%) recipients with the external iliac artery preferred for anastomosis with the allograft renal artery in end-to-side fashion in 182 (86.7%) cases. The internal iliac artery was used in end-to-end fashion anastomosis in 28 (13.3%) of cases. Ureteroneocystostomy using the Modified Lich-Gregoir technique over a double-J stent was performed in all but 5 patients who had uretero-ureterostomies. Significant peri-operative hemorrhage necessitating blood transfusion was experienced in 9 donors and 26 recipients. There was a low complication rate in kidney donors. Allograft renal artery thrombosis, venous thrombosis, and arterial pseudo-aneurysms were encountered in 3, 2 and 4 recipients respectively. Kidney transplantation can be safely and routinely carried out in Nigeria. The early surgical outlook of both kidney donors and recipients was found to be excellent in this study.

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Urine Bacteriology in Post-Kidney Transplant Patients with Double-J Stents

Cited by 2 publications

References 17 publications

Bacterial Colonization in Double J Stent and Bacteriuria in Post-Renal Transplant Patients

Bacterial Colonization in Double J Stent and Bacteriuria in Post-Renal Transplant Patients

Kidney Transplantation in Nigeria: A Single Centre’s Early Surgical Experience and Outcomes

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