Outcomes of Kidney Transplant Recipients With Posttransplant Genitourinary Infectious Complications: A Single Center Study
| Autor: | Randall S. Sung, Dushyanth Srinivasan, John T. Stoffel, Kori Bradley |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Urinary system Single Center Reproductive Tract Infections Risk Assessment Young Adult Risk Factors Internal medicine medicine Electronic Health Records Humans Antibiotic prophylaxis Survival analysis Retrospective Studies Transplantation business.industry Genitourinary system Graft Survival Hazard ratio Retrospective cohort study Middle Aged Kidney Transplantation Anti-Bacterial Agents Treatment Outcome Urinary Tract Infections Cohort Female business |
| Zdroj: | Experimental and Clinical Transplantation. 17:470-477 |
| ISSN: | 2146-8427 1304-0855 |
| DOI: | 10.6002/ect.2017.0196 |
| Popis: | OBJECTIVES Long-term outcomes of kidney transplant recipients with postoperative genitourinary tract infections are not well characterized. In this single center retrospective study, we aimed to investigate the long-term effects of early posttransplant genitourinary infections under a protocol that included 1 month of antibiotic prophylaxis on graft failure and patient outcomes. MATERIALS AND METHODS Electronic medical records of 1752 recipients of kidney-alone transplant between January 2000 and December 2008 were reviewed. Of these, 344 patients had postoperative genitourinary tract infections within 6 months of transplant. Infections included urinary tract infections, recurrent urinary tract infections, and pyelonephritis. All patients received 1-month of treatment with antibiotic prophylaxis for genitourinary infections after graft placement. Kaplan-Meier survival curves and multivariable regression modeling were performed to determine survival outcomes. RESULTS In the 344 patients with postoperative infections, the most common cause was Escherichia coli (34.9%). Kaplan-Meier graft survival results showed no significant differences (P = .08) among those with and those without postoperative urinary tract infections; however, patient survival (P = .01) was significantly different. Multivariate analysis demonstrated no significant trend regarding graft failure (hazard ratio: 1.28; 95% confidence interval, 0.95-1.71; P = .09) or patient death (hazard ratio: 1.33; 95% confidence interval, 0.98-1.79; P = .06) in patients with and without genitourinary infections. The major cause of graft failure was infection in the infection cohort (17.4%). CONCLUSIONS Kidney transplant recipients who develop urinary tract infections within 6 months of transplant may be at increased risk of graft failure or patient death; however, further studies are needed to elucidate the relationship between posttransplant infections and long-term outcomes. |
| Databáze: | OpenAIRE |
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