title: Prospective study of urinary tract infection surveillance after kidney transplantation.
abstract: BACKGROUND
  Urinary tract infection (UTI) remains one of the main complications after kidney transplantation and it has serious consequences.
  
  
  METHODS
  Fifty-two patients with kidney transplantation were evaluated for UTI at 3-145 days (mean 40.0 days) after surgery.. Forty-two received a graft from a live donor and 10 from a deceased donor. There were 22 female and 30 male patients, aged 11-47 years. Microscopic examinations, leukocyte esterase stick, and urinary culture were performed every third day and weekly after hospitalization. A positive culture was consider when patients presented bacterial counts up to 105 counts.
  
  
  RESULTS
  UTI developed in 19/52 (37%) patients at 3-75 days (mean 19.5 days after transplantation. Recurrent infection was observed in 7/52 (13.4%) patients at days 17-65. UTI was more frequent in patients who received deceased grafts compared with live grafts (7/10, 70% vs. 12/42, 28%; p < 0.007). Female patients were more susceptible than male (11/22, 50% vs. 8/22, 36.35%; p < 0.042). Five-year survival rate was 94.5% (49/52 patients). Kidney Graft exit update is 47/52 (90.2%), and there were no significant differences between graft rejection and UTI (p = 0.2518). Isolated bacteria were Escherichia coli (31.5%), Candida albicans (21.0%) and Enterococcus spp. (10.5%), followed by Pseudomonas aeruginosa, Klebsiella pneumoniae, Morganella morganii, Enterobacter cloacae and Micrococcus spp. Secondary infections were produced by (7/19, 36.8%). Enterococcus spp. (57%), E. coli (28%) and Micrococcus spp. (14.2%). Antibiotic resistance was 22% for ciprofloxacin and 33% for ampicillin. Therapeutic alternatives were aztreonam, trimethoprim-sulfamethoxazole, netilmicin and fosfomycin.
  
  
  CONCLUSIONS
  Surveillance of UTI for the first 3 months is a good option for improving quality of life of kidney transplantation patients and the exit of graft function especially for female patients and those receiving deceased grafts. Antibiograms provided a good therapeutic alternative to patients who presented with UTIs after receiving a kidney allograft.
authors: Microbiology Research Laboratory, Hospital Juárez de México, Avenida Instituto Politécnico Nacional, México, DF 07760, México.
authors: Roberto
authors: R
authors: Rivera-Sanchez
authors: Dolores
authors: D
authors: Delgado-Ochoa
authors: Rocio R
authors: RR
authors: Flores-Paz
authors: Elvia E
authors: EE
authors: García-Jiménez
authors: Ramon
authors: R
authors: Espinosa-Hernández
authors: Andres A
authors: AA
authors: Bazan-Borges
authors: Myriam
authors: M
authors: Arriaga-Alba
mesh_terms: D000293:Adolescent; D000328:Adult; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D015995:Prevalence; D011446:Prospective Studies; D016019:Survival Analysis; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D055815:Young Adult