BACKGROUND: Urinary tract infection (UTI) is a well-recognized early complication in renal transplant recipients (RTR) and can have significant bearing on their outcome.
The recent rise in incidence of extended spectrum beta lactamase (ESBL) producing bacteria causing UTI among RTR poses new and significant challenges in terms of management and outcome. Our aim is to analyze the effect of ESBL producing bacteria causing UTI in these patients and its impact on allograft function.
METHODS: We reviewed the medical records of 147 RTR who were followed at a tertiary care hospital affiliated transplant center between January 2007 and May 2013 and noted five RTR who developed episodes of ESBL producing bacteria related UTI during follow up. Multiple patient characteristics including demographics, immunosuppression, recurrences, allograft function and outcome were analyzed.
RESULTS: Five patients (3.4%) out of 147 had ESBL producing bacteria related UTI. We found all patients to be above 60 years of age, with three out of five being females, and all five patients had diabetes mellitus. We identified a total of 37 episodes of UTI among these five patients during this period. Two of these patients had elevated creatinine values during the episodes of UTI and three of them developed bacteremia. Of the five patients, four of them had a favorable outcome except for one patient who developed persistent allograft dysfunction.
CONCLUSION: RTR are at a higher risk for developing ESBL producing bacteria associated UTI. Early diagnosis along with appropriate and judicious use of antibiotics will ensure long term success in allograft and patient outcome.
Written by:
Ramadas P, Rajendran PP, Krishnan P, Alex A, Siskind E, Kadiyala A, Jayaschandran V, Basu A, Bhaskaran M, Molmenti EP. Are you the author?
Transplant Program, North Shore University Hospital, Manhasset, New York, United States of America; Department of Surgery, North Shore University Hospital, Manhasset, New York, United States of America; Department of Nephrology, North Shore University Hospital, Manhasset, New York, United States of America.
Reference: PLoS One. 2014 Mar 17;9(3):e91289.
doi: 10.1371/journal.pone.0091289
PubMed Abstract
PMID: 24637786
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