Urinary tract infection in the renal transplant patient

Nat Clin Pract Nephrol. 2008 May;4(5):252-64. doi: 10.1038/ncpneph0781. Epub 2008 Mar 11.

Abstract

Urinary tract infection (UTI) is the most common type of bacterial infection contracted by recipients of renal allografts in the post-transplantation period. Fungi and viruses can also cause UTIs, but infections caused by these organisms are less common than those caused by bacteria. Both the lower and upper urinary tract (encompassing grafted or native kidneys) can be affected. Factors that might contribute to the development of UTIs include excessive immunosuppression, and instrumentation of the urinary tract (e.g. urethral catheters and ureteric stents). Antimicrobials are the mainstays of treatment and should be accompanied by minimization of immunosuppression when possible. The use of long-term antimicrobial prophylaxis is controversial, however, as it might increase the likelihood of infective organisms becoming resistant to treatment. There are conflicting data on the associations of post-transplantation UTI with graft and patient survival.

Publication types

  • Review

MeSH terms

  • Anti-Infective Agents, Urinary / administration & dosage
  • Female
  • Graft Rejection
  • Graft Survival
  • Humans
  • Incidence
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods
  • Male
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Prognosis
  • Risk Assessment
  • Severity of Illness Index
  • Survival Rate
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / etiology*

Substances

  • Anti-Infective Agents, Urinary