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Screening for asymptomatic bacteruria at one month after adult kidney transplantation: Clinical factors and implications
Author(s) -
Goh Yen Seow Benjamin,
Deng Zhaolong,
Cheong Pei Shan Cassandra,
Raman Lata,
Goh Ting Hui Angeline,
Vathsala Anatharaman,
Tiong Ho Yee
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12954
Subject(s) - medicine , asymptomatic , immunosuppression , transplantation , urinary system , kidney transplantation , population , incidence (geometry) , surgery , pediatrics , physics , environmental health , optics
Objective Urinary tract infections ( UTI s) account for significant morbidity after kidney transplantation ( KT ). Screening for asymptomatic bacteruria ( AB ) has proven to be beneficial in certain population including pregnant women; however, it is not well‐studied in KT population. We reviewed the incidence, clinical features, and implications of asymptomatic bacteruria one month after KT . Methods A total of 171 adult KT patients (86 [50.3%] living transplants, 87 [50.9%] males, mean age 47.3 ± 13.7 years), between 2005 and 2012, were analyzed. Immunosuppression induction and maintenance were as per protocol. Protocol urine cultures were taken at 1 month post‐transplantation. Patients were stratified for presence of AB and analyzed for demographics and clinical parameters. Outcomes of hospitalization for symptomatic UTI s, graft, and patient survival were ascertained. Results Forty‐one (24%) KT recipients had AB at 30 days post‐transplant. Multiresistant organisms accounted for 43.9% of these infections. Logistic regression confirms female sex and deceased donor recipients as independent predictors of 30‐day bacteruria, which predicts subsequent hospitalization for symptomatic UTI . One‐year patient and graft survival were similar in recipient with or without AB . Conclusion Asymptomatic bacteruria 30 days post‐transplant can be predicted in female recipients and kidneys from deceased donors probably due to anatomical and functional differences respectively. There is increased morbidity of subsequent hospitalization for symptomatic UTI and more research in prevention of UTI is needed, particularly non‐antibiotic prophylaxis.