Study of the risk factors related to acquisition of urinary tract infections in patients submitted to renal transplant

Rev Soc Bras Med Trop. May-Jun 2015;48(3):285-90. doi: 10.1590/0037-8682-0098-2015.

Abstract

Introduction: Urinary tract infections (UTI) among transplant recipients are usually caused by gram-negative microorganisms and can provoke a high incidence of morbidity and mortality. The aim of this study was to evaluate the risk factors associated with the acquisition of UTIs during the first year after renal transplantation.

Methods: Here, we report a single-center retrospective cohort study of 99 renal transplant patients followed for the first year after surgery. The definition of a UTI episode was a urine culture showing bacterial growth and leucocyturia when patients presented with urinary symptoms. The absence of infection (asymptomatic bacteriuria) was defined as an absence of symptoms with negative urine culture or bacterial growth with any number of colonies.

Results: Ninety-nine patients were included in the study. During the study, 1,847 urine cultures were collected, and 320 (17.3%) tested positive for bacterial growth. Twenty-six (26.2%) patients developed a UTI. The most frequent microorganisms isolated from patients with UTIs were Klebsiella pneumoniae (36%), with 33% of the strains resistant to carbapenems, followed by Escherichia coli (20%). There were no deaths or graft losses associated with UTI episodes.

Conclusions: Among the UTI risk factors studied, the only one that was associated with a higher incidence of infection was female sex. Moreover, the identification of drug-resistant strains is worrisome, as these infections have become widespread globally and represent a challenge in the control and management of infections, especially in solid organ transplantation.

MeSH terms

  • Adult
  • Aged
  • Brazil / epidemiology
  • Epidemiologic Methods
  • Female
  • Humans
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Time Factors
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / microbiology*
  • Young Adult