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Impact of antibiotic resistance on the development of recurrent and relapsing symptomatic urinary tract infection in kidney recipients.
Am J Transplant. 2015 Apr; 15(4):1021-7.AJ

Abstract

We sought to determine the frequency, risk factors, and clinical impact of recurrent urinary tract infections (UTI) in kidney transplant recipients. Of 867 patients who received a kidney transplant between 2003 and 2010, 174 (20%) presented at least one episode of UTI. Fifty-five patients presented a recurrent UTI (32%) and 78% of them could be also considered relapsing episodes. Recurrent UTI was caused by extended-spectrum betalactamase (ESBL)-producing Klebsiella pneumoniae (31%), followed by non-ESBL producing Escherichia coli (15%), multidrug-resistant (MDR) Pseudomonas aeruginosa (14%), and ESBL-producing E. coli (13%). The variables associated with a higher risk of recurrent UTI were a first or second episode of infection by MDR bacteria (OR 12; 95%CI 528), age >60 years (OR 2.2; 95%CI 1.15.1), and reoperation (OR 3; 95%CI 1.37.1). In addition, more relapses were recorded in patients with UTI caused by MDR organisms than in those with susceptible microorganisms. There were no differences in acute rejection, graft function, graft loss or 1 year mortality between groups. In conclusion, recurrent UTI is frequent among kidney recipients and associated with MDR organism. Classic risk factors for UTI (female gender and diabetes) are absent in kidney recipients, thus highlighting the relevance of uropathogens in this population.

Authors+Show Affiliations

Infectious Diseases Department, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25676738

Citation

Bodro, M, et al. "Impact of Antibiotic Resistance On the Development of Recurrent and Relapsing Symptomatic Urinary Tract Infection in Kidney Recipients." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, vol. 15, no. 4, 2015, pp. 1021-7.
Bodro M, Sanclemente G, Lipperheide I, et al. Impact of antibiotic resistance on the development of recurrent and relapsing symptomatic urinary tract infection in kidney recipients. Am J Transplant. 2015;15(4):1021-7.
Bodro, M., Sanclemente, G., Lipperheide, I., Allali, M., Marco, F., Bosch, J., Cofan, F., Ricart, M. J., Esforzado, N., Oppenheimer, F., Moreno, A., & Cervera, C. (2015). Impact of antibiotic resistance on the development of recurrent and relapsing symptomatic urinary tract infection in kidney recipients. American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 15(4), 1021-7. https://doi.org/10.1111/ajt.13075
Bodro M, et al. Impact of Antibiotic Resistance On the Development of Recurrent and Relapsing Symptomatic Urinary Tract Infection in Kidney Recipients. Am J Transplant. 2015;15(4):1021-7. PubMed PMID: 25676738.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of antibiotic resistance on the development of recurrent and relapsing symptomatic urinary tract infection in kidney recipients. AU - Bodro,M, AU - Sanclemente,G, AU - Lipperheide,I, AU - Allali,M, AU - Marco,F, AU - Bosch,J, AU - Cofan,F, AU - Ricart,M J, AU - Esforzado,N, AU - Oppenheimer,F, AU - Moreno,A, AU - Cervera,C, Y1 - 2015/02/12/ PY - 2014/07/15/received PY - 2014/10/10/revised PY - 2014/10/13/accepted PY - 2015/2/14/entrez PY - 2015/2/14/pubmed PY - 2015/12/19/medline KW - antibiotic drug resistance KW - bacterial KW - clinical research/practice KW - infection and infectious agents KW - infectious disease SP - 1021 EP - 7 JF - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons JO - Am. J. Transplant. VL - 15 IS - 4 N2 - We sought to determine the frequency, risk factors, and clinical impact of recurrent urinary tract infections (UTI) in kidney transplant recipients. Of 867 patients who received a kidney transplant between 2003 and 2010, 174 (20%) presented at least one episode of UTI. Fifty-five patients presented a recurrent UTI (32%) and 78% of them could be also considered relapsing episodes. Recurrent UTI was caused by extended-spectrum betalactamase (ESBL)-producing Klebsiella pneumoniae (31%), followed by non-ESBL producing Escherichia coli (15%), multidrug-resistant (MDR) Pseudomonas aeruginosa (14%), and ESBL-producing E. coli (13%). The variables associated with a higher risk of recurrent UTI were a first or second episode of infection by MDR bacteria (OR 12; 95%CI 528), age >60 years (OR 2.2; 95%CI 1.15.1), and reoperation (OR 3; 95%CI 1.37.1). In addition, more relapses were recorded in patients with UTI caused by MDR organisms than in those with susceptible microorganisms. There were no differences in acute rejection, graft function, graft loss or 1 year mortality between groups. In conclusion, recurrent UTI is frequent among kidney recipients and associated with MDR organism. Classic risk factors for UTI (female gender and diabetes) are absent in kidney recipients, thus highlighting the relevance of uropathogens in this population. SN - 1600-6143 UR - https://www.unboundmedicine.com/medline/citation/25676738/Impact_of_Antibiotic_Resistance_on_the_Development_of_Recurrent_and_Relapsing_Symptomatic_Urinary_Tract_Infection_in_Kidney_Recipients_ L2 - https://doi.org/10.1111/ajt.13075 DB - PRIME DP - Unbound Medicine ER -