title: Simultaneous pancreas-kidney transplantation: infectious complications and microbiological aspects.
abstract: OBJECTIVE
  The purpose of this study was to describe the clinical and microbiological characteristics of the infectious complications among simultaneous pancreas-kidney transplantations (SPKT).
  
  
  METHODS
  Among the first 45 SPKT the mean age was 34 years (range, 21 to 49) and the mean duration of follow-up 13 months (range, 2 to 27 months).
  
  
  RESULTS
  Twenty-three patients (51%) presented at least one to three episodes (1.7 mean) of infectious complications that needed hospitalization. The etiology of the infections included 71% bacterial (44% gram-negative rods and 27% gram-positive cocci), 16% viral (12% from CMV and 4% from Herpes sp) and 13% fungal (8% by Candida sp and 4% by others fungus). Wound and urinary infections were most frequent, occurring in 22% and 28% of the patients, respectively. All patients who were submitted to vesical drainage developed infections in contrast a rate of only 44% among patients undergoing enteric drainage.
  
  
  CONCLUSIONS
  Infectious complications are the main cause of morbidity and mortality following simultaneous pancreas-kidney transplantation, especially with vesical drainage. The use of enteric drainage combined with administration of broad spectrum prophylactic antibiotics is recommended.
authors.affiliation: São Paulo Federal University Medical School-UNIFESP, Sao Paulo, SP, Brazil. marbet@uol.com.br
authors.forename: M M
authors.initials: MM
authors.lastname: Linhares
authors.forename: A M
authors.initials: AM
authors.lastname: Gonzalez
authors.forename: T
authors.initials: T
authors.lastname: Triviño
authors.forename: M M L S
authors.initials: MM
authors.lastname: Barbosa
authors.forename: V
authors.initials: V
authors.lastname: Schraibman
authors.forename: C
authors.initials: C
authors.lastname: Melaragno
authors.forename: R M A M
authors.initials: RM
authors.lastname: Moura
authors.forename: M H G
authors.initials: MH
authors.lastname: Silva
authors.forename: J R
authors.initials: JR
authors.lastname: Sá
authors.forename: W F
authors.initials: WF
authors.lastname: Aguiar
authors.forename: E B
authors.initials: EB
authors.lastname: Rangel
authors.forename: C B
authors.initials: CB
authors.lastname: Serra
authors.forename: T
authors.initials: T
authors.lastname: Succi
authors.forename: J O M
authors.initials: JO
authors.lastname: Pestana
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000453:epidemiology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology*; D012189:Retrospective Studies; D013997:Time Factors