title: Urinary tract infections in the early posttransplant period after kidney transplantation: etiologic agents and their susceptibility.
abstract: OBJECTIVE
  Urinary tract infection (UTI) is among the most common infections in solid organ transplantation, especially in kidney transplantation.
  
  
  METHODS
  This study included 295 adult patients undergoing KTx between September 2001 and December 2007. All patients were followed prospectively for UTI during the first 4 weeks after surgery. Samples of urine were investigated by bacteriological cultures to identify microorganisms in accord with standard procedures. Susceptibility testing was performed using Clinical and Laboratory Standards Institute procedures.
  
  
  RESULTS
  Urine specimens (n=582) were obtained from 84.5% of 245 recipients during the first month after transplantation. Among the isolated bacterial strains (n=291), the most common were Gram-negative bacteria (56.4%) predominantly Serratia marcescens (32.3%) and Enterobacter cloacae (14.6%). Extended- spectrum beta-lactamase (ESBL+) strains were isolated in 52.5% of cases. Gram-positive bacteria comprised 35.7%; most commonly, high-level aminoglycoside resistant (HLAR; 87.8%) and vancomycin-resistant (VRE; 11%) Enterococci. There were fungal strains in 23 cases (7.9%).
  
  
  CONCLUSIONS
  Our study showed predominantly Gram-negative rods from the Enterobacteriaceae family comprising (84.8%) of Gram-negative isolates: 52.5% ESBL and resistant enterococci (87.5%) in Gram-positive isolates. The increased proportion of isolates of multi-drug-resistant bacterial agents which can cause severe UTIs may be due to our frequent use of ceftriaxone for perioperative bacterial prophylaxis.
authors: Department of Medical Microbiology, Medical University of Warsaw, Warsaw, Poland. dkawecki@o2.pl
authors: D
authors: D
authors: Kawecki
authors: A
authors: A
authors: Kwiatkowski
authors: A
authors: A
authors: Sawicka-Grzelak
authors: M
authors: M
authors: Durlik
authors: L
authors: L
authors: Paczek
authors: A
authors: A
authors: Chmura
authors: G
authors: G
authors: Mlynarczyk
authors: W
authors: W
authors: Rowinski
authors: M
authors: M
authors: Luczak
mesh_terms: D000328:Adult; D001437:Bacteriuria / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D016972:Enterobacter cloacae; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors; D016868:Serratia Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D012706:Serratia marcescens; D013997:Time Factors; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology