title: Infectious complications and antibiotic use in renal transplant recipients during a 1-year follow-up.
abstract: OBJECTIVE
  To evaluate infectious complications and antibiotic use in 192 renal transplant recipients.
  
  
  METHODS
  Infectious complications and antibiotic use were monitored in all patients receiving renal transplantation at our center from 1992 to 1997. Risk factors for infectious complications were evaluated. Transplants and patient survival were monitored. The follow-up period was 1 year.
  
  
  RESULTS
  One-hundred and ninety-two patients received renal transplants during the study period. The mean duration of urethral catheterisation after transplantation was 10.5 days (SD = 5). Seventy-one per cent (n = 137) of patients had at least one infectious episode. In all, 284 infectious episodes were monitored. The most frequent infections were: urinary tract infections 61%, respiratory tract infections 8%, intra-abdominal infections 7%, and cytomegalovirus infection 8%. Escherichia coli and Enterococcus faecalis were the most frequently isolated microorganisms. Seventy-four per cent (n = 142) of patients received 314 antimicrobial courses (284 for therapy, and 30 for prophylaxis). Female gender and duration of urethral catheterisation were risk factors for urinary tract infection. Cytomegalovirus reactivation was associated with acute graft rejection and additional immunosuppressive therapy. Overall mortality was 4%. Infection-related mortality was 2.6%. Mortality was associated with Enterobacteriaceae in three patients, with Pseudomonas aeroginosa in one patient and with Enterococcus faecalis in one patient.
  
  
  CONCLUSIONS
  The incidence of infectious complications remains high in renal transplant recipients. Most cases of mortality were associated with infections. Early removal of the urethral catheter to reduce the risk of urinary tract infections is recommended.
authors.affiliation: Department of Medical Microbiology St Elisabeth Hospital, PO Box 747, Tilburg, 5000 AS, the Netherlands. b.maraha@elisabeth.nl
authors.forename: B
authors.initials: B
authors.lastname: Maraha
authors.forename: H
authors.initials: H
authors.lastname: Bonten
authors.forename: H
authors.initials: H
authors.lastname: van Hooff
authors.forename: H
authors.initials: H
authors.lastname: Fiolet
authors.forename: A G
authors.initials: AG
authors.lastname: Buiting
authors.forename: E E
authors.initials: EE
authors.lastname: Stobberingh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control; D003586:Cytomegalovirus Infections / Q000517:prevention & control / Q000821:virology; D005260:Female; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology* / Q000209:etiology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000382:microbiology / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents