Evaluation of urinary tract infections in a two-year follow-up after renal transplantation: a single center experience

Abstract

Introduction: After renal transplantation, urinary tract infection (UTI) is observed in 23-75% of cases. In this study, we aimed to investigate the incidence of UTIs after renal transplantation, the causative pathogens and the predisposing factors that increase the risk. Methodology: Patients who underwent renal transplantation in our hospital between 2016-2017 were included in the study. Results: Twenty-five patients who underwent kidney transplantation were included in the study. UTI was detected in 12 patients (48%). One patient had neurogenic bladder, three had nephrolithiasis and one had vesicoureteral reflux. 8 of the patients had at least two UTI attacks. In total 38 UTI attacks; There were 7 (18.4%) nitrite positivity. UTI was detected in 15 (39.5%) patients during the first 3 months after transplantation. While 7 (18.4%) of the urine cultures were gram positive and 27 (71.1%) were gram negative bacteria, 4 (10.5%) were found as contamination. Escherichia coli (34.2%) was the most common causative agent, followed by Klebsiella pneumoniae (21.1%), Enterococcus faecium (18.4%), Pseudomonas aeruginosa (5.3%) and other gram negative (%). 10.5 uropathogens were found to be followed. When compared with basal and UTI GFR (glomerular filtration rate) levels, the GFR values detected during UTI were decreased significantly (p=0.00). The most frequently preferred antibiotics in UTI treatment were ertapenem 42.1%, levofloxacin 10.5%, seftriaxon 10.5% and fosfomycin 10.5%. Conclusion: Improperly treated UTI negatively affects the outcome of transplantation and increases mortality. Therefore, risk factors, antibiotic resistance and empirical treatments should be reviewed and treatment success should be increased.