title: Urinary tract infection in renal transplant recipients: incidence, risk factors, and impact on graft function.
abstract: BACKGROUND
  Urinary tract infection (UTI) is the most common infection posttransplant. However, the risk factors for and the impact of UTIs remain controversial. The aim of this study was to identify the incidence of posttransplant UTIs in a series of renal transplant recipients from deceased donors. Secondary objectives were to identify: (1) the most frequent infectious agents; (2) risk factors related to donor; (3) risk factors related to recipients; and (4) impact of UTI on graft function.
  
  
  METHODS
  This was a retrospective analysis of medical records from renal transplant patients from January to December 2010. Local ethics committee approved the protocol.
  
  
  RESULTS
  The incidence of UTI in this series was 34.2%. Risk factors for UTI were older age, (independent of gender), biopsy-proven acute rejection episodes, and kidneys from deceased donors (United Network for Organ Sharing criteria). For female patients, the number of pretransplant pregnancies was an additional risk factor. Recurrent UTI was observed in 44% of patients from the UTI group. The most common infectious agents were Escherichia coli and Klebsiella pneumoniae, for both isolated and recurrent UTI. No difference in renal graft function or immunosuppressive therapy was observed between groups after the 1-year follow-up.
  
  
  CONCLUSIONS
  In this series, older age, previous pregnancy, kidneys from expanded criteria donors, and biopsy-proven acute rejection episodes were risk factors for posttransplant UTI. Recurrence of UTI was observed in 44%, with no negative impact on graft function or survival.
authors.affiliation: Division of Nephrology, Department of Medicine, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: L F
authors.initials: LF
authors.lastname: Camargo
authors.affiliation: Division of Nephrology, Department of Medicine, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: A B A
authors.initials: AB
authors.lastname: Esteves
authors.affiliation: Division of Nephrology, Department of Medicine, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: L R S
authors.initials: LR
authors.lastname: Ulisses
authors.affiliation: Division of Nephrology, Department of Medicine, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: G G
authors.initials: GG
authors.lastname: Rivelli
authors.affiliation: Division of Nephrology, Department of Medicine, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil. Electronic address: marildamazzali@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Mazzali
mesh_terms: D000328:Adult; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D007710:Klebsiella Infections / Q000453:epidemiology / Q000209:etiology*; D007711:Klebsiella pneumoniae; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology*