title: Screening for asymptomatic bacteruria at one month after adult kidney transplantation: Clinical factors and implications.
abstract: Urinary tract infections (UTIs) account for significant morbidity after kidney transplantation (KT). Screening for asymptomatic bacteruria (AB) has proven to be beneficial in certain population including pregnant women; however, it is not well-studied in KT population. We reviewed the incidence, clinical features, and implications of asymptomatic bacteruria one month after KT.
  
  
  
  A total of 171 adult KT patients (86 [50.3%] living transplants, 87 [50.9%] males, mean age 47.3 ± 13.7 years), between 2005 and 2012, were analyzed. Immunosuppression induction and maintenance were as per protocol. Protocol urine cultures were taken at 1 month post-transplantation. Patients were stratified for presence of AB and analyzed for demographics and clinical parameters. Outcomes of hospitalization for symptomatic UTIs, graft, and patient survival were ascertained.
  
  
  
  Forty-one (24%) KT recipients had AB at 30 days post-transplant. Multiresistant organisms accounted for 43.9% of these infections. Logistic regression confirms female sex and deceased donor recipients as independent predictors of 30-day bacteruria, which predicts subsequent hospitalization for symptomatic UTI. One-year patient and graft survival were similar in recipient with or without AB.
  
  
  
  Asymptomatic bacteruria 30 days post-transplant can be predicted in female recipients and kidneys from deceased donors probably due to anatomical and functional differences respectively. There is increased morbidity of subsequent hospitalization for symptomatic UTI and more research in prevention of UTI is needed, particularly non-antibiotic prophylaxis.
authors.affiliation: Department of Urology, National University Hospital, Singapore city, Singapore.
authors.forename: Yen Seow Benjamin
authors.identifier: 0000-0001-8979-5919
authors.initials: YSB
authors.lastname: Goh
authors.affiliation: Department of Urology, National University Hospital, Singapore city, Singapore.
authors.forename: Zhaolong
authors.initials: Z
authors.lastname: Deng
authors.affiliation: Department of Urology, National University Hospital, Singapore city, Singapore.
authors.forename: Pei Shan Cassandra
authors.initials: PSC
authors.lastname: Cheong
authors.affiliation: Department of Urology, National University Hospital, Singapore city, Singapore.
authors.forename: Lata
authors.initials: L
authors.lastname: Raman
authors.affiliation: National University Centre for Organ Transplantation, National University Hospital, Singapore city, Singapore.
authors.forename: Ting Hui Angeline
authors.initials: THA
authors.lastname: Goh
authors.affiliation: National University Centre for Organ Transplantation, National University Hospital, Singapore city, Singapore.
authors.forename: Anatharaman
authors.initials: A
authors.lastname: Vathsala
authors.affiliation: Department of Urology, National University Hospital, Singapore city, Singapore.|National University Centre for Organ Transplantation, National University Hospital, Singapore city, Singapore.
authors.forename: Ho Yee
authors.initials: HY
authors.lastname: Tiong
mesh_terms: D000328:Adult; D001419:Bacteria / Q000472:pathogenicity*; D001437:Bacteriuria / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors
keywords: kidney; screening; transplantation; urinary tract infection