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THE OUTCOME OF URINARY TRACT INFECTIONS IN PATIENTS AFTER HUMAN CADAVERIC RENAL TRANSPLANTATION
Author(s) -
LEIGH D. A.
Publication year - 1969
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1969.tb09940.x
Subject(s) - transplantation , urinary system , medicine , kidney transplantation , antibiotics , kidney , surgery , biology , microbiology and biotechnology
SUMMARY Seventeen (68 per cent.) of 25 patients developed a urinary tract infection following human cadaver renal transplantation. Infection was more common in women and occurred in all patients in whom chronic pyelonephritis was the cause of the primary renal failure. The first episode of infection occurred within 14 days of the transplantation in 14 of the 17 patients and was commonly associated with catheterisation. Fifty recurrences of infection occurred and the average number of recurrences was the same for men and for women. Only one patient in the infected group did not have a recurrence of infection. Forty‐seven per cent. of the patients who developed an infection after transplantation had a past history of infection; none of the uninfected patients had such a history. There was no relationship between the ischæmia time and renal function of the transplanted kidney and the development of infection. The source of the infecting organism was probably the fæces in 65 per cent. of the Esch. coli infections and all of the infections due to Ps. cæroginosa. Proteus and Klebsiella infections were frequently secondary to abscesses in the area of the transplanted kidney. The results of treatment were poor only 52 per cent. of infections responding to antibiotics. Reinfection with a different serotype or species occurred in 45 per cent. of these infections. Urinary tract infection following renal transplantation could be classified into the following types: infection which was unrelated to transplantation and which responded well to treatment and infection which was related to the operation and was either catheter‐induced, due to bladder dysfunction, or associated with a renal or ureteric lesion: the results of treatment were variable. The importance of urinary tract infection after transplantation depends on the site of the infection, but careful treatment and follow‐up are necessary to prevent the development of infection in the transplanted kidney or to limit the degree of renal damage produced by an established renal tissue infection.