Symptomatic and asymptomatic bacteriuria in a pediatric cohort of kidney transplants from a hospital in Paraguay
| Autor: | Fernando Galeano, Marcos Roberto Tovani-Palone, Víctor Araya, Soraya Araya, Marlene Martínez Pico, Avelina Victoria Troche, Nidia Gómez |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
business.industry Septic shock Incidence (epidemiology) Retrospective cohort study General Medicine Bacteriuria bacterial infections and mycoses medicine.disease Asymptomatic Ciprofloxacin Transplantation Internal medicine Intensive care Medicine medicine.symptom business medicine.drug |
| Zdroj: | Electronic Journal of General Medicine. 16:em152 |
| ISSN: | 2516-3507 |
| DOI: | 10.29333/ejgm/108496 |
| Popis: | Introduction:Bacteriuria is common in kidney transplant recipients (KTR) and it may affect graft survival.Objective:To describe the incidence, clinical manifestations and microbial susceptibility of the symptomatic (SB) and asymptomatic (AB) bacteriuria in KTR, and to define the initial empirical treatment.Methods:Retrospective cohort study of all KTR 12 months in 54.5%. The median time between the transplantation and the first AB episode was 3 months, and between the first SB episode was 7 months. The symptoms found in patients with SB included fever (80%), hematuria (15%) and septic shock (5%). No patient died due to urinary tract infections (UTI), but 33.3% of the patients with bacteriuria required admission to intensive care units. The most frequent bacteria isolated was Escherichia coli (E.coli) (54.5%). Extended‐spectrum beta‐lactamase (ESBL) producing bacteria was found in 20% of the isolates. When comparing SB and AB, E.coli was associated with SB (p=0.047 OR:1-9.9). All SB cases were verified in patients with neurogenic bladder (p=0.013).Conclusion:The recognition of high incidence of ESBL producing bacteria- related to UTI in (children) KTR may be very important for decision on the use of antibiotics during post- transplantation period. In this case, the use of carbapenem and ciprofloxacin should be recommended as initial empiric treatment. |
| Databáze: | OpenAIRE |
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