2020, Number 2
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Rev Nefrol Dial Traspl 2020; 40 (2)
Impact of asymptomatic bacteriuria on renal transplantation. retrospective cohort study
Fragale G, Franco R, Magenta M, Karl A, Beitía V, Tisi BM
Language: Spanish
References: 13
Page: 99-105
PDF size: 189.33 Kb.
ABSTRACT
Introduction: Asymptomatic bacteriuria (AB)
during the first year post-renal transplantation
has an incidence higher than 50%. Urinary tract
infection (UTI) is the most frequent complication
of renal transplantation; its incidence is between
30 and 70 % during the first year.
Objective:
To analyze the incidence of UTI and AB
during the first year post-renal transplantation
and their impact on renal function.
Methods:
Retrospective study in renal transplantation
patients older than 18 between January 2006
and December 2017 in our center. Patients who
had received combined renal transplantation, lost
renal graft during the first year due to surgical
complications (thrombosis, allograft rupture)
or medical complications (rejection, underlying
disease recurrence) were excluded.
Results: A
study was performed with 161 adult patients
who had undergone kidney transplantation. The
incidence of UTI and AB during the first year
after receiving transplantation was 32% and
25%, respectively. The mean renal function one
year after transplantation was as follows: (n=53)
Cr 1.36(±0.44) for UTI patients; (n=30) Cr
1.36(±0.41) for AB non-treated patients; (n=11)
Cr 1.39(±0.42) for AB treated patients, and
(n=90) Cr 1.31(±0.43) p=0.95 for patients not
suffering from UTI or AB. The risk of UTI was
55 % for non-treated AB and 57% for treated AB,
with RR 0.96 (95% CI: 0.52-1.8).
Conclusion:
No significant differences in renal function were
found in UTI and AB patients one year after
transplantation as compared to patients not
suffering from these conditions. AB treatment
did not reduce UTI risk.
REFERENCES
Parasuraman R, Julian K; AST Infectious DiseasesCommunity of Practice. Urinary tract infectionsin solid organ transplantation. Am J Transplant. 2013;13(Suppl 4):327-36. doi:10.1111/ajt.12124.
Fiorante S, López-Medrano F, Lizasoain M, LaluezaA, Juan RS, Andrés A, et al. Systematic screeningand treatment of asymptomatic bacteriuria in renaltransplant recipients. Kidney Int. 2010;78(8):774-81.doi:10.1038/ki.2010.286.
Bodro M, Sanclemente G, Lipperheide I, Allali M,Marco F, Bosch J, et al. Impact of urinary tractinfections on short-term kidney graft outcome. ClinMicrobiol Infect. 2015;21(12):1104.e1-8. doi:10.1016/j.cmi.2015.07.019.
El Amari EB, Hadaya K, Bühler L, Berney T, RohnerP, Martin PY, et al. Outcome of treated and untreatedasymptomatic bacteriuria in renal transplant recipients.Nephrol Dial Transplant. 2011;26(12):4109-14.doi:10.1093/ndt/gfr198.
Green H, Rahamimov R, Goldberg E, Leibovici L,Gafter U, Bishara J, et al. Consequences of treatedversus untreated asymptomatic bacteriuria in the firstyear following kidney transplantation: retrospectiveobservational study. Eur J Clin Microbiol Infect Dis.2013;32(1):127-31. doi:10.1007/s10096-012-1727-2.
Coussement J, Scemla A, Abramowicz D, Nagler EV,Webster AC. Antibiotics for asymptomatic bacteriuriain kidney transplant recipients. Cochrane DatabaseSyst Rev. 2018;2:CD011357. doi:10.1002/14651858.CD011357.pub2.
Coussement J, Maggiore U, Manuel O, Scemla A,López-Medrano F, Nagler EV, et al. Diagnosis andmanagement of asymptomatic bacteriuria in kidneytransplant recipients: a survey of current practice inEurope. Nephrol Dial Transplant. 2018;33(9):1661-1668. doi:10.1093/ndt/gfy078.
Gołębiewska JE, Dębska-Ślizień A, Rutkowski B.Urinary tract infections during the first year after renaltransplantation: one center’s experience and a reviewof the literature. Clin Transplant. 2014;28(11):1263-70.doi:10.1111/ctr.12465.
van Delden C, Blumberg EA; AST Infectious DiseasesCommunity of Practice. Multidrug resistant gramnegativebacteria in solid organ transplant recipients.Am J Transplant. 2009;9(Suppl 4):S27-34. doi:10.1111/j.1600-6143.2009.02890.x.
Kotagiri P, Chembolli D, Ryan J, Hughes PD,Toussaint ND. Urinary tract infections in thefirst year post-kidney transplantation: potentialbenefits of treating asymptomatic bacteriuria.Transplant Proc. 2017;49(9):2070-2075. doi:10.1016/j.transproceed.2017.07.008.
Moradi M, Abbasi M, Moradi A, Boskabadi A,Jalali A. Effect of antibiotic therapy on asymptomaticbacteriuria in kidney transplant recipients. Urol J.2005;2(1):32-5.
Origüen J, López-Medrano F, Fernández-Ruiz M,Polanco N, Gutiérrez E, González E, et al. Shouldasymptomatic bacteriuria be systematically treated inkidney transplant recipients? Results from a randomizedcontrolled trial. Am J Transplant. 2016;16(10):2943-2953. doi:10.1111/ajt.13829.
Sabé N, Oriol I, Melilli E, Manonelles A, Bestard O,Polo C, et al. Antibiotic Treatment versus no treatmentfor asymptomatic bacteriuria in kidney transplantrecipients: a multicenter randomized trial. Open ForumInfect Dis. 2019;6(6):ofz243. doi:10.1093/ofid/ofz243.