[Clinical, epidemiologic, and microbiologic study of urinary infection in patients with renal transplant at a specialized center in Argentina].
Sixty-four patients were evaluated for urinary tract infection (UTI) during the first six months after renal transplantation. Eighty per cent received the allograft from a living, related donor and 37% were female. The median age was 33.8 years. All the patients received cefazolin as perioperative antibiotic prophylaxis. No prophylaxis was given during the bladder catheterization period, which had a median duration of 5.9 days. Nineteen per cent developed predisposing urological factors (PUF). The incidence of UTI was 41% and 15% of all these patients developed bacteremia from this source. UTI was observed in 50% of the patients without PUF between the 5th and 12th days post-transplantation, and these cases had been detected by the control urine culture performed when the bladder catheter was withdrawn. This group of patients accounted for 14% of all the patients. Recurrence was present in 42% of the patients with UTI (19% had reinfection, 4% relapse and 19% both). They were more frequent in patients with PUF than in the patients without; 78% vs. 24%, respectively (p < 0.05). The overall UTI incidence was also higher; 75% vs. 33%, respectively (p < 0.05). The same was observed for the median number of episodes (3 vs. 1). The organisms most frequently isolated were E. faecalis (21%). E. cloacae (17%), and E. coli (17%). Species prevalence differs from that of other reports, probably due to the different institutional antibiotic management. Since half of the UTI episodes suffered by patients without PUF were associated to bladder catheterization, there is a need to institute antibiotic prophylaxis in our center.
Bantar
C
C
Servicio de Nefrología, Centro de Educación Médica e Investigaciones Clínicas (CEMIC) Norberto Quirno, Buenos Aires, Argentina.
Fernández Canigia
L
L
Díaz
C
C
Ibáñez
C
C
Soto
M
M
Smayevsky
J
J
Rovegno
A
A
Fernández
H
H
Bianchi
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology