title: Antibiotic prophylaxis at urinary catheter removal prevents urinary tract infection after kidney transplantation.
abstract: BACKGROUND
  Urinary tract infections (UTI) are common nosocomial infections in kidney transplant recipients, with limited evidence to guide antibiotic prophylaxis at urinary catheter removal. The aim of our study was to evaluate the effect of short-term antibiotic therapy at the moment of catheter removal after kidney transplantation.
  
  
  METHODS
  Twenty kidney transplant recipients received 250 mg of ciprofloxacin orally twice daily 1 day before and at the day of the removal of the urinary catheter and were compared with 20 kidney transplant recipients without prophylaxis. UTI was diagnosed by use of urine culture and clinical signs.
  
  
  RESULTS
  All patients were comparable in sex, age, etiology of end-stage renal failure, immunosuppression, donor type, and initial function. After catheter removal at the 6th postoperative day, a rapid rise of UTI in kidney transplant recipients without prophylaxis (n = 12, 60%) was observed, whereas in patients with antibiotic prophylaxis the rate of UTI could be significantly reduced to 20%. Escherichia coli was the most isolated pathogen in the patients with UTI and was detected at the catheter tip in more than 50% of cases. In 2 patients (10%) after antibiotic prophylaxis, a ciprofloxacin-resistant E coli strain was detected.
  
  
  CONCLUSIONS
  The use of antibiotic prophylaxis during urinary catheter removal is recommended to prevent UTI in kidney transplant recipients.
authors.affiliation: Department of General and Visceral Surgery, University Clinic Muenster, Muenster, Germany. Electronic address: heiner.wolters@ukmuenster.de.
authors.forename: H H
authors.initials: HH
authors.lastname: Wolters
authors.affiliation: Department of General and Visceral Surgery, University Clinic Muenster, Muenster, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Palmes
authors.affiliation: Department of General and Visceral Surgery, University Clinic Muenster, Muenster, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Lordugin
authors.affiliation: Department of General and Visceral Surgery, University Clinic Muenster, Muenster, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Bahde
authors.affiliation: Department of General and Visceral Surgery, University Clinic Muenster, Muenster, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Senninger
authors.affiliation: Department of General Surgery, Herz-Jesu-Krankenhaus-Münster-Hiltrup, Muenster, Germany.
authors.forename: J-P
authors.initials: JP
authors.lastname: Hölzen
authors.affiliation: Department of General and Visceral Surgery, University Clinic Muenster, Muenster, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Kebschull
mesh_terms: D019072:Antibiotic Prophylaxis / Q000379:methods*; D003428:Cross Infection / Q000517:prevention & control*; D020878:Device Removal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D062885:Urinary Catheters / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control*