Profile, Risk Factors, and Outcomes of Asymptomatic Bacteriuria in Kidney Transplant Recipients with Normal Pretransplant Genitourinary Tract: A Single-Center Experience.

Autor: Mani SSR; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., Thomas A; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., Alam R; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., Lalwani M; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., Valson AT; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., Yadav B; Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India., Eapen JJ; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., John EE; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., Yusuf S; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., Mukha RP; Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India., Rajadoss MKP; Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India., Mercy D; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., Alexander S; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., Varughese S; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India., David VG; Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India.
Jazyk: angličtina
Zdroj: Indian journal of nephrology [Indian J Nephrol] 2024 Jan-Feb; Vol. 34 (1), pp. 37-44. Date of Electronic Publication: 2023 Jun 05.
DOI: 10.4103/ijn.ijn_407_22
Abstrakt: 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.
Competing Interests: There are no conflicts of interest.
(© 2024 Indian Journal of Nephrology | Published by Scientific Scholar.)
Databáze: MEDLINE
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