Urinary Tract Infections in the Early Posttransplant Period After Kidney Transplantation: Etiologic Agents and Their Susceptibility

• Published in: Transplantation proceedings Vol. 43; no. 8; pp. 2991 - 2993
• Main Authors: Kawecki, D, Kwiatkowski, A, Sawicka-Grzelak, A, Durlik, M, Paczek, L, Chmura, A, Mlynarczyk, G, Rowinski, W, Luczak, M
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01.10.2011; Elsevier
• Subjects: Adult; Bacterial diseases; Bacterial diseases of the urinary system; Bacteriuria - drug therapy; Bacteriuria - etiology; Bacteriuria - microbiology; Biological and medical sciences; Drug Resistance, Multiple, Bacterial; Enterobacter cloacae; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - etiology; Enterobacteriaceae Infections - microbiology; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Human bacterial diseases; Humans; Infectious diseases; Kidney Transplantation - adverse effects; Male; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Mycoses - drug therapy; Mycoses - etiology; Mycoses - microbiology; Prospective Studies; Risk Factors; Serratia Infections - drug therapy; Serratia Infections - etiology; Serratia Infections - microbiology; Serratia marcescens; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Time Factors; Tissue, organ and graft immunology; Urinary Tract Infections - drug therapy; Urinary Tract Infections - etiology; Urinary Tract Infections - microbiology; Urinary system disease; Pathogenesis; Period; Urinary tract disease; Homotransplantation; Genetic determinism; Kidney; Medicine; Urinary tract infection; Sensitivity; Treatment; Urinary system; Etiology; Surgery; Predisposition; Graft; Early; Kidney transplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.09.002

Abstract Objective Urinary tract infection (UTI) is among the most common infections in solid organ transplantation, especially in kidney transplantation. Patients and Methods This study included 295 adult patients undergoing KTx between September 2001 and December 2007. All patients were followed prospectively for UTI during the first 4 weeks after surgery. Samples of urine were investigated by bacteriological cultures to identify microorganisms in accord with standard procedures. Susceptibility testing was performed using Clinical and Laboratory Standards Institute procedures. Results Urine specimens ( n = 582) were obtained from 84.5% of 245 recipients during the first month after transplantation. Among the isolated bacterial strains ( n = 291), the most common were Gram-negative bacteria (56.4%) predominantly Serratia marcescens (32.3%) and Enterobacter cloacae (14.6%). Extended- spectrum beta-lactamase (ESBL+) strains were isolated in 52.5% of cases. Gram-positive bacteria comprised 35.7%; most commonly, high-level aminoglycoside resistant (HLAR; 87.8%) and vancomycin-resistant (VRE; 11%) Enterococci. There were fungal strains in 23 cases (7.9%). Conclusion Our study showed predominantly Gram-negative rods from the Enterobacteriaceae family comprising (84.8%) of Gram-negative isolates: 52.5% ESBL and resistant enterococci (87.5%) in Gram-positive isolates. The increased proportion of isolates of multi-drug–resistant bacterial agents which can cause severe UTIs may be due to our frequent use of ceftriaxone for perioperative bacterial prophylaxis.