title: Bacterial urinary tract infection in renal transplant recipients and their antibiotic resistance pattern: A four-year study.
abstract: OBJECTIVE
  Urinary tract infections (UTIs) are the most common infections in renal transplant recipients and are considered a potential cause of bacteremia, sepsis, and affects graft outcomes. The aim of the present study was to determine the incidence of UTI among renal transplant recipients and investigation of antimicrobial susceptibility pattern of causative agents.
  
  
  METHODS
  In total, 1165 patients from March 2009 to December 2012, in transplant center of Golestan Hospital, Ahvaz, Iran, were investigated. Qualitative urine cultures were performed for all cases, causative microorganisms were identified and colony count was performed according to the standard protocol. Antibiotic susceptibility testing was then performed to determine the susceptibility pattern of recovered bacteria from confirmed UTIs.
  
  
  RESULTS
  UTI was diagnosed in 391 patients(33.56%). Gram-negative bacteria were the most prevalent isolated microorganisms with E. coli (43.53%), followed by Enterobacter spp. (35.37%) as the major organisms. Among Gram positives, Coagulase-negative Staphylococci was isolated from 6.8% of cases. The rate of resistance to all tested antibiotics was highest in Enterobacter spp., however the most common resistance were seen against cefixime, cephalotin, and cotrimoxazole in all tested gram negatives.
  
  
  CONCLUSIONS
  the rate of UTIs among renal transplant recipients was noticeable in this study with high antibiotic resistance. Multi-resistant bacterial infections are potentially life-threatening emerging problem in renal transplantation. Prophylactic measures must be applied to patients at greater risk.
authors.affiliation: Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ; Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Azar Dokht
authors.initials: AD
authors.lastname: Khosravi
authors.affiliation: Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Effat
authors.initials: E
authors.lastname: Abasi Montazeri
authors.affiliation: Internal Medicine Ward, Golestan Teaching hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ghorbani
authors.affiliation: Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran ; Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Najmeh
authors.initials: N
authors.lastname: Parhizgari
keywords: Urinary tract infection; antibiotic susceptibility; transplant recipients