title: Urinary Tract Infections Among Hospitalized Adults in the Early Post-Liver Transplant Period: Prevalence, Risk Factors, Causative Agents, and Microbial Susceptibility.
abstract: OBJECTIVE
  Urinary tract infections are among the most common infections after liver transplant, especially soon after surgery. This study analyzed urinary tract infections or bacteriuria, their causative agents, and related risk factors in the early period after liver transplant in hospitalized adult transplant recipients in the main liver transplant referral center in Iran.
  
  
  METHODS
  In this prospective study, 389 consecutive adult patients who underwent liver transplant at the Nemazee Teaching Hospital were enrolled between October 2014 and October 2015. Risk factors were compared for patients who developed urinary tract infections or bacteriuria ("infection group "; n = 63 [16.2% ]) and patients without evidence of infection ("control group "; n = 211 [54.2% ]). Patients with sites of infection other than the urinary tract were excluded. Antimicrobial sus ceptibility testing was performed using the Kirby-Bauer disk-diffusion method. Univariate and multivariate analyses compared variables between the 2 groups.
  
  
  RESULTS
  Seventy-nine episodes of urinary tract infections or bacteriuria occurred in the infection group. Multiple logistic regression analysis showed that female sex, hospitalization 2 to 7 days before transplant, and frequency of abdominal exploration were 11.0, 5.9, and 3.0 times more common in the infection group than in the control group. The chance of infection rises 1.1 times with each one unit increase of body mass index. The most common infection causes were gram-negative bacteria (n = 50; 63.3%), predominantly Escherichia coli (n = 24; 30.4%); followed by gram-positive bacteria (n = 20; 25.3%), predominantly Enterococcus species (n = 14; 17.8%) that had a high incidence of vancomycin resistance (n = 10; 71.4%); and non-Candida albicans species isolates (n = 9; 11.4%).
  
  
  CONCLUSIONS
  Urinary tract infections are a common infection in hospitalized adult patients soon after liver transplant. Female sex, hospitalization shortly before transplant, more frequent abdominal exploration, and higher body mass index substantially increased the risk of developing such infections in this period.
authors.affiliation: Alborzi Clinical Microbiology Research Center, Shiraz, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Pouladfar
authors.forename: Zahra
authors.initials: Z
authors.lastname: Jafarpour
authors.forename: Mohammad
authors.initials: M
authors.lastname: Firoozifar
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Malek Hosseini
authors.forename: Razieh
authors.initials: R
authors.lastname: Rasekh
authors.forename: Leila
authors.initials: L
authors.lastname: Khosravifard
authors.forename: Parisa
authors.initials: P
authors.lastname: Janghorban
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015992:Body Mass Index; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D007492:Iran / Q000453:epidemiology; D016031:Liver Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents