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e-Article

Profile, Risk Factors, and Outcomes of Asymptomatic Bacteriuria in Kidney Transplant Recipients with Normal Pretransplant Genitourinary Tract: A Single-Center Experience.
Document Type
Article
Source
Indian Journal of Nephrology. Jan/Feb2024, Vol. 34 Issue 1, p37-44. 8p.
Subject
*KIDNEY transplantation
*RISK assessment
*URINARY tract infections
*PATIENTS
*TRANSPLANTATION of organs, tissues, etc.
*GRAFT survival
*CYSTITIS
*DRUG resistance in microorganisms
*SEX distribution
*BACTERIURIA
*TREATMENT effectiveness
*PYELONEPHRITIS
*SEPSIS
*BETA lactamases
*CARBAPENEM-resistant bacteria
*DISEASE risk factors
Language
ISSN
0971-4065
Abstract
Introduction: There is a paucity of studies on asymptomatic bacteriuria (ASB) among kidney transplant recipients (KTR) in developing countries. This study assessed the clinical profile, risk factors, outcomes, and impact of treatment of ASB in KTRs with a normal genitourinary tract. Methods: Consecutive KTRs from 2009 to 2018 with no clinical or radiological evidence of obstructive uropathy were included. Urinary tract infection (UTI) after ASB was defined as occurrence of cystitis, pyelonephritis, or urosepsis, with ASB being the first bacteriuric episode. Results: Seven hundred ten out of 794 patients with median follow up of 47 months were included. The mean age was 35.5 ± 12 years. Eighty-one patients (11.4%) developed ASB at a median of 25 days (IQR 10, 134.5). Fifty-three percent and 4.9% of ASB episodes were extended-spectrum beta-lactamase (ESBL) positive and carbapenem-resistant organisms, respectively. Eighteen patients (32.1%) with early ASB (<3 months) and 5 (20%) with late ASB developed UTI on follow-up. Fifty-five percent of early and 16% of late ASB episodes were treated, with no significant difference observed in the risk of development of UTI when compared to untreated ASB episodes. Conclusion: The incidence of ASB as first bacteriuric episode in our cohort was 11.4%, with there being significant antimicrobial resistance. Female gender, pretransplant UTI, and delayed graft function were independently associated with development of ASB. Treatment of ASB episodes either early or late did not decrease the risk of development of UTI. [ABSTRACT FROM AUTHOR]