Elsevier

Transplantation Proceedings

Volume 42, Issue 1, January–February 2010, Pages 280-281
Transplantation Proceedings

Renal transplantation
Complication
Risk Factors for Urinary Tract Infections During the First Year After Kidney Transplantation

https://doi.org/10.1016/j.transproceed.2009.11.029Get rights and content

Abstract

Introduction

Urinary tract infections (UTI) have been reported to occur with frequencies ranging from 30% to 60% in kidney transplant recipients during the first year posttransplantation. UTI is the main cause of infectious complications in this period. The objective of this study was to evaluate the incidence of UTI, during the first year posttransplantation and to identify the risk factors associated with its development, as well as its impact on graft function.

Patients and Methods

This retrospective cohort study had as a primary outcome the development of UTI, defined as the presence of more than 100,000 colony-forming units (CFU) of a pathogenic organism by mL of urine. The univariate analysis was performed with chi-square test for categorical variables and Student t test for continuous ones metrics. We performed multivariate analysis with logistic regression. P < .05 was considered statistically significant.

Results

We studied 176 kidney transplant recipients, including 54.5% of male gender and with an overall average age of 37 ± 12 years. The UTI incidence was of 35.8% (n = 63). The bacterium most frequently found in urine cultures was Escherichia coli (n = 46). In this study, the risk factors that were independently associated with UTI development were age, female gender, days of bladder catheterization, genitourinary anatomic alterations, and UTI during 1 month prior to kidney transplantation.

Conclusion

This type of study makes it possible to identify risk factors and to formulate strategies focused on particular risk factors.

Section snippets

Patients and Methods

This retrospective cohort study was based upon clinical files of patients who received a renal transplant in our center between January 2003 and December 2007, excluding 2 patients who lost their grafts in the first week due to acute antibody-mediated rejection. The primary outcome was the development of UTI, which was defined as the presence of more than 100,000 colony-forming units (CFU) of a pathogenic organism per mL urine. The univariate analysis was performed with chi-square test for

Results

Among the 176 subjects 54.5% were males and the overall average age was 37 ± 12 years. The UTI incidence was of 35.8% (n = 63). The bacterium most frequently found in urine cultures was Escherichia coli (n = 46). Twenty percent (n = 13) of patients who developed UTI displayed acute rejection episodes (P = .85) and 25% (n = 16) had biopsy-proven interstitial fibrosis and tubular atrophy (IF/TA) (P = .77). Upon univariate analysis, the risk factors associated with UTI development in the first

Discussion

In this study, the UTI incidence was 35.8%, which is similar to that reported by other centers. The risk factors associated with the development of UTI were similar to those previously described: age, female gender, posttransplantation genito-urinary alterations, days of bladder catheter placement, and history of UTI in the month prior to the transplantation.1, 2, 3 In our cohort, UTI was not associated with a deleterious effect on graft function. An important observation is that many of these

References (4)

There are more references available in the full text version of this article.

Cited by (51)

  • Perioperative Considerations Regarding Sex in Solid Organ Transplantation

    2020, Anesthesiology Clinics
    Citation Excerpt :

    Posttransplant infection puts recipients at risk for graft failure, and female sex has been associated with increased incidence of posttransplant bacterial infection.39 Specifically, women were shown to have higher rates of urinary tract infections posttransplant compared with male recipients, prompting discussions about considering antibiotic prophylaxis postoperatively.40 Female renal transplant recipients also had higher rates of iron deficiency anemia posttransplant.41

  • Long-term outcomes in lupus patients receiving different renal replacement therapy

    2019, Journal of Microbiology, Immunology and Infection
View all citing articles on Scopus
View full text