ESBL-producing enterobacteriaceae-related urinary tract infections in kidney transplant recipients: incidence and risk factors for recurrence

Autor: Zahar, Scemla A, Benoit Pilmis, Mamzer Mf, Olivier Lortholary, Legendre C, Olivier Join-Lambert
Rok vydání: 2015
Předmět:
Adult
Male
Microbiology (medical)
medicine.medical_specialty
Time Factors
Urinary system
Urology
Bacteriuria
urologic and male genital diseases
Kidney transplant
beta-Lactamases
Young Adult
Enterobacteriaceae
Recurrence
Risk Factors
Internal medicine
Humans
Medicine
Prospective Studies
Escherichia coli Infections
Kidney transplantation
Aged
Retrospective Studies
Aged
80 and over
General Immunology and Microbiology
biology
business.industry
Incidence
Incidence (epidemiology)
Enterobacteriaceae Infections
Retrospective cohort study
General Medicine
Middle Aged
bacterial infections and mycoses
medicine.disease
biology.organism_classification
Antimicrobial
Kidney Transplantation
Transplant Recipients
female genital diseases and pregnancy complications
Anti-Bacterial Agents
Infectious Diseases
Urinary Tract Infections
Female
France
business
Zdroj: Infectious Diseases. 47:714-718
ISSN: 2374-4243
2374-4235
DOI: 10.3109/23744235.2015.1051107
Popis: Urinary tract infections (UTIs) represent the first cause of bacterial infections in renal transplant recipients. In a period of increasing resistance to antimicrobial agents, the factors leading to the development of UTI in previously urinary colonized renal transplant recipients as well as the factors associated with recurrence of UTIs have to be determined. The aims of this retrospective study were (1) to assess the incidence of extended-spectrum beta-lactamase-producing enterobacteriaceae (ESBL-PE)-related UTI in kidney transplant recipients, (2) to identify factors associated with ESBL-PE infection and (3) to determine the risk factors for recurrence.We included all kidney transplant recipients admitted in our hospital between January 2009 and January 2012 who had a monobacterial ESBL-PE UTI or bacteriuria.During the study period, 659 patients underwent kidney transplantation; 72 patients had ESBL-PE bacteriuria, representing a 10.9% prevalence, and among the latter 34 (47.2%) presented an ESBL-PE-related UTI. Fourteen patients (41.2%) experienced a UTI relapse associated with two factors: advanced age (p = 0.032) and persistent bacteriuria 48 h after appropriate antibiotic therapy (p = 0.04). No other risk factor for recurrence was found, including the presence and management of a ureteral stent during the first UTI, causative microorganisms, or diabetes mellitus.In this specific population, regarding the risk of relapse there is an urgent need for prospective studies to test the best treatment strategy.
Databáze: OpenAIRE
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