Spectrum of asymptomatic bacteriuria in renal allograft recipients and its short-term effect on graft outcome: Experience of a Tertiary Care Center from Northwest India

• Published in: Indian journal of transplantation Vol. 13; no. 1; pp. 20 - 24
• Main Authors: Sharma, Gaurav, Agarwal, Dhananjay, Rathore, Vinay, Pandey, Alok, Jhorawat, Rajesh, Sharma, Sanjeev, Beniwal, Pankaj, Malhotra, Vinay
• Format: Journal Article
• Language: English
• Published: Medknow Publications and Media Pvt. Ltd 01.01.2019; Wolters Kluwer Medknow Publications
• Subjects: Asymptomatic bacteriuria; Bacteriuria; Basiliximab; Care and treatment; Chronic kidney failure; Complications and side effects; graft outcome; Health aspects; Kidney transplantation; Medical research; Microbiology; Mycophenolate sodium; Organ transplant recipients; postrenal transplant; Risk factors; spectrum of asymptomatic bacteriuria; Surgery; Valganciclovir; India
• ISSN: 2212-0017; 2212-0025
• DOI: 10.4103/ijot.ijot_52_18

Introduction: Asymptomatic bacteriuria (AB) is not uncommon after renal transplantation with limited data from developing countries; we did this study to assess the microbiological spectrum and its short-term graft outcome in our tertiary care center. Materials and Methods: It is a prospective observational study. We included all the patients who underwent renal transplantation over a period of 18 months, from January 2016 to June 2017. Patients who had indwelling urinary catheter beyond 5 days posttransplant and those with persistent graft dysfunction within 6 months of transplant were excluded from the study. Results: A total of 67 patients were included in the study with a mean age of 33.78 ± 8.91 years and a male-to-female ratio of 7:1; live-related donors were 36 (53.73%), live unrelated were 19 (28.35%), and 12 (17.91%) were cadaveric renal allograft recipients (RARs). Twenty-eight (41.79%) patients had 42 episodes of AB over 6 months of follow-up. The maximum episodes occurred within 1 month of postrenal transplantation, and 42 out of 67 (62.68%) RARs had bacterial growth in their double-J ureteral stents (USs). The most frequently isolated pathogen from urine was Escherichia coli (n = 14, 33.33%), whereas Pseudomonas aeruginosa (n = 10, 23.80%) was in US culture (USC). The prevalence of AB was higher in cadaveric RARs compared to live RARs (83.33% vs. 32.72%, P = 0.001) and with bacterial growth in the USC compared to those who did not show any growth in USs (57.14% vs. 16.0%, P = 0.001). However, the estimated glomerular filtration rate between those with AB and those without at 6 months of follow-up (66.36 ± 14.98 vs. 66.10 ± 13.83 ml/min/1.73 m2, P = 0.943) was not different. Conclusion: AB is not uncommon in RARs and it is more common in cadaveric RARs and those with growth in US culture without compromise in allograft function at 6 months postrenal transplant.