The impact of urinary tract infections in renal transplant recipients

Background: Urinary tract infections (UTIs) represent the most common cause of bacterial infection in renal allograft recipients. The purpose of this study was to evaluate UTI in renal transplant recipients at earlier post transplant period (first 3 months) and isolation of causative organism. Materials & methods: We studied 31 patients (18 males and 13 females), aged 27 ± 8.8 years. UTIs occurring during the first three months were analyzed. During this period, all episodes of infection, transplant function, graft survival and patient survival were monitored. Results: Twenty two patients had suffered from different types of infection within first 3 months of transplantation, most of the infectious episodes occurred during hospital stay. Most of the infection occurred in urinary tract and most of the episodes of UTI were asymptomatic, presented with bacteriuria. Most of the isolated organisms were Gram negative E.Coli. Out of 51 episodes of bacterial infection, UTIs account for 49 episodes (96%) Patients’ age, sex and acute rejection episodes did not correlate with UTI. Patient who had prolonged urethral catheterization had suffered from significantly more number of UTI in comparison to short period of urethral catheterization (p=0.02).Similar incidence of UTI were observed in ureteric stented and non stented patients but non stented patients had suffered from significant number of urological complication (p<0.02) . Antibiotic sensitivity pattern revealed that, all isolates were sensitive to ciprofloxacin, ceftriaxone and ceftazidime, ranged between, 67 to 100% and highly resistant to ampicillin, cotrimoxazole and cephradine. Conclusion : Short term renal graft function was not found to be affected by UTI occurrence. UTIs are common infectious complications in renal transplant recipients and often relapse and require hospitalization. Keyword: urinary tract infections (UTIs), renal transplantation, acute rejection episodes. DOI: http://dx.doi.org/10.3329/jom.v12i2.8416 JOM 2011; 12(2): 103-108

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2662. Methenamine Hippurate Decreases the Incidence of Urinary Tract Infections in Adult Renal Transplant Recipients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2340 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S931-S932

Author(s):

Orlando Quintero ◽

Yoram Puius ◽

Vagish Hemmige

Keyword(s):

Urinary Tract ◽

Renal Transplant ◽

Creatinine Clearance ◽

Kidney Transplant ◽

Urinary Tract Infections ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Transplant Patients ◽

Number Of Patients ◽

Tract Infections

Abstract Background Urinary tract infections (UTIs) are a common complication of renal transplantation. Methenamine hippurate is a non-antibiotic alternative that reduces the frequency of UTIs in selected non-transplant patients, but which is not recommended in renal insufficiency. We conducted a retrospective study to determine the efficacy of methenamine prophylaxis in our kidney transplant population, and identify subgroups for which efficacy is greatest. Methods Retrospective chart review of adult kidney transplant patients at Montefiore Medical Center who were prescribed methenamine during January 1, 2016–December 31, 2017, with extraction of clinical data in the year before and after prophylaxis. Variables included demographics, creatinine clearance and hemoglobin A1c levels at the time of prescription, incidence of UTIs as determined by standardized literature definitions, hospital admissions for infections, and antibiotic use. Results The incidence of UTIs per 1000 patient-days decreased significantly, from 9.66 (95% CI 7.53–12.40) the year before to 3.24 (95% CI 2.00–5.24) the year after (P < 0.001). The effect was significantly more pronounced in patients who were transplanted due to diabetic nephropathy, with a decreased incidence of 13.05 (95% Cl 10.00–17.02) UTIs/1000 patient-days to 2.90 (95% Cl 1.58–5.32) in diabetics (P < 0.001), vs. 5.50 (95% Cl 3.65–8.28) UTIs/1000 patient-days to 3.81 (95% Cl 1.70–8.55) in non-diabetics (P = 0.44). The number of days of antibiotics for UTIs per 1000 days also decreased significantly for all patients, from 128.58 (95% CI 94.87–174.28) the year before to 49.78 (95% CI 31.74–78.07) the year after (P = 0.001). No significant differences in efficacy were seen based on sex or renal function. Three patients with indwelling urinary catheters or who required intermittent catheterization did not appear to benefit Conclusion Methenamine prophylaxis decreases the incidence of UTIs and number of antibiotic days in adult renal transplant recipients. This effect was seen even in patients with reduced creatinine clearance. Patients with diabetes benefited the most. The small number of patients who required catheterization did not appear to benefit. Disclosures All authors: No reported disclosures.

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