title: Infections in renal transplant patients: risk factors and infectious agents.
abstract: OBJECTIVE
  Infectious complications after renal transplantation (RT) are associated with significant morbidity. They continue to be the most frequent cause of mortality. We investigated the incidence of infections, the causative pathogens, and risk factors contributing to this complication during the first year.
  
  
  METHODS
  We included demographic and clinical data of the 124 patients who underwent RT in our hospital from December 2004 to June 2010. for statistical analysis.
  
  
  RESULTS
  Fifty (40.3%) RT recipients developed 80 episodes of infection: urinary tract (n = 68; 85%), intraabdominal (n = 4; 5%), surgical wound (n = 3; 3.8%), or central venous catheter (n = 3; 4%). Eight (10%) were bacteremic. The most commonly isolated bacteria scene (76/80) was Escherichia coli (n = 43; 56.5%) followed by Klebsiella spp. (n = 10; 13.2%) and Pseudomonas spp. (n = 10; 13.2%). Cytomegalovirus infection was detected in 2 recipients; fungal and mycobacterial infections, in no case. It was noteworthy that 52.8% of E. coli and Klebsiella spp. produced extended-spectrum beta-lactamase. Ninety percent of infections developed within 6 months after transplantation. When we compared infected versus noninfected cases, the presence of a double J catheter was the most significant risk factor (P = .018; odds ratio [OR] = 0.234; 95% confidence interval [CI] = 0.070-0.781). In contrast to the initial years after the start of RT in our hospital the incidence of infection decreased over time together with a decrease number and durations of catheterization (P = .008; OR = 2.707; 95% CI = 1.292-5.672).
  
  
  CONCLUSIONS
  Urinary tract infections were the predominant problem with most isolates resistant to extended-spectrum antibiotics. Therefore, invasive catheters and prophylactic antibiotics should not be used for longer than necessary and infection control measures implemented to decrease the incidence of infections and bacterial resistance.
authors.affiliation: Clinic of Infectious Diseases, Kartal Research and Education Hospital, Istanbul, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Ak
authors.forename: M
authors.initials: M
authors.lastname: Yildirim
authors.forename: H F
authors.initials: HF
authors.lastname: Kucuk
authors.forename: S
authors.initials: S
authors.lastname: Gencer
authors.forename: T
authors.initials: T
authors.lastname: Demir
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007239:Infections / Q000453:epidemiology*; D016030:Kidney Transplantation; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors