[Early urinary tract infection in kidney transplantation. Risk factors and impact on graft survival].
The early urinary tract infection (EUTI) in kidney transplant recipients is an infection develop during the first 3 months post transplant surgery. The effect of EUTI on graft survival and risk factors have been scarcely studied. Our objetives were the evaluation of risk factors to EUTI, the assessment of the causal agent and graft survival impact. A retrospective analysis of kidney transplantation, period 1997-2000 in Hospital Privado-Centro Médico de Córdoba was carried out. There were two groups of patients with (EUTI group) and without EUTI (control group). Cox model was used to analyze risk factors and Kaplan-Meier method for graft survival. A total of 226 consecutive patients received kidney transplantation. In 55 patients (24.3%) EUTI was detected. Risk factors for EUTI were: invasive urological maneuvers (RR = 4.34, CI 95% 1.42-13.21), diabetes mellitus (RR = 3.79, CI 95% 1.42-10.14), cytomegalovirus infection (RR = 2.9, CI 95% 1.02-8.24) and previous transplants (RR = 2.83, CI 95% 1.08-7.45). Delayed graft function was associated with lower incidence of EUTI (RR = 0.38, CI 95% 0.15-0.94). The causal agents were: Klebsiella pneumoniae (36%), Pseudomonas aeruginosa (24%) and Escherichia coli (9%). Graft survival at 2 years was similar in EUTI (87.2%) and control group (81.2%, p = 0.32). This series shows that invasive urological maneuvers were the main risk factors for EUTI. Graft survival was similar. High prevalence of non coli bacteria need further evaluation.
Cepeda
Pablo A
PA
Servicio de Nefrología, Hospital Privado, Centro Médico de Córdoba.
Balderramo
Domingo C
DC
De Arteaga
Javier
J
Douthat
Walter G
WG
Massari
Pablo U
PU
D000328:Adult; D004812:Epidemiologic Methods; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology