[Infectious complications in 159 consecutive kidney transplant recipients].
BACKGROUND
The incidence of infections has decreased in kidney transplant (KT) recipients owing to advances in the surgical techniques and clinical management of this population. Nevertheless, these complications continue to occur and the causes seem to be changing, in part because of the prophylactic strategies used.


METHODS
Prospective, observational study investigating infections occurring during the first 2 years post-transplantation in KT recipients who underwent surgery between July 2003 and December 2005 at Hospital Universitario Virgen del Rocío. Univariate and multivariate regression analysis was performed to determine risk factors associated with the development of infection.


RESULTS
The incidence of infection was 1.11 episodes per patient over 510+/-234 days. The most common infections were urinary tract infection (UTI) (46.6%), cytomegalovirus (CMV) infection (22.7%), and surgical site infection (8%). The causes were bacterial (50.4%), viral (45.9%), and fungal (3.6%) agents. The most frequent pathogens were CMV (36%), Escherichia coli (28%), extended-spectrum beta-lactamase (ESBL)-producers (26%), and coagulase-negative staphylococci (6.3%). Seventy-nine percent of infection episodes occurred in the 4 months following KT. One recipient died 30 days after the infection episode. In the infection group, patient and graft survival at the end of follow-up was 98% and 89%, respectively.


CONCLUSIONS
The most frequent syndromes were UTI, CMV infection and surgical site infection. The infections were mainly produced by bacteria, in particular gram-negative rods, and there was a high rate of ESBL E. coli.
García-Prado
María Elena
ME
Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla, España. pharmaelena@hotmail.es
Cordero
Elisa
E
Cabello
Virginia
V
Pereira
Porfirio
P
Torrubia
Francisco Javier
FJ
Ruíz
Maite
M
Cisneros
José Miguel
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000453:epidemiology; D003141:Communicable Diseases / Q000453:epidemiology*; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology; D014777:Virus Diseases / Q000453:epidemiology; D055815:Young Adult