Abstract
Purpose: Urinary tract infections are the most common infections early after kidney transplantation. The goals of this study were to evaluate our perioperative antibiotic protocol and risk factors for the occurrence of urinary tract and its effect on the early graft function. We evaluated laboratory alterations during episodes of UTI regarding their potential to guide treatment.Methods: Retrospective single-center analysis of all kidney transplant recipients of an academic transplant center between 2015 and 2017.Results: 96 patients were included in the study. Overall, in 22 patients a asymptomatic bacteriuria (ASB) was detected and 33 patients developed a urinary tract infection (UTI). Gram-negative UTIs appeared earlier than gram-positive UTIs. The most common lab findings during UTI were leukocytosis and CRP increase, both more common in gram-negative UTI (p .00 & .03). All complicated UTIs were caused by gram-negative bacteria (p .00). No difference in UTIs was seen between perioperative antibiotic regimens. Patients that suffered from UTIs showed less favorable graft function at discharge (GFR 43 vs 52 ml / min, p .03).Conclusion: UTIs are associated with worse graft functions while ASBs are not. Whether UTIs are caused by or lead to decreased graft function is still unclear. Proper gram-negative coverage is needed in cases of complicated UTIs or severe laboratory findings. Perioperative antibiotic regimens appear to have no beneficial influence on the incidence of UTIs.
Prevalence and risk factor analysis of resistant Escherichia coli urinary tract infections in the emergency department