Evaluation of urinary tract infections in a two-year follow-up after renal transplantation: a single center experience

Tugba Sarı; Belda Dursun; Mevlüt Çeri; İlknur Kaleli; Hüseyin Turgut; Murat Özban

Makale detayları

Evaluation of urinary tract infections in a two-year follow-up after renal transplantation: a single center experience

Yazarlar:

Tugba Sarı | Belda Dursun | Mevlüt Çeri | İlknur Kaleli | Hüseyin Turgut | Murat Özban

Yayıncı:

Pamukkale University

Ana Başlıklar:

Bulaşıcı Hastalıklar

Dergi:

Pamukkale Tıp Dergisi Vol.16 Issue 1, pp.51-57

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001281229

pISSN:

1308-0865

Anahtar kelimeler:

Özet:

 Introduction: After renal transplantation, urinary tract infection UTI is observed in 23-75 of cases. In this study, we aimed to investigate the incidence of UTIs after renal transplantation, the causative pathogens and the predisposing factors that increase the risk. Methodology: Patients who underwent renal transplantation in our hospital between 2016-2017 were included in the study. Results: Twenty-five patients who underwent kidney transplantation were included in the study. UTI was detected in 12 patients 48. One patient had neurogenic bladder, three had nephrolithiasis and one had vesicoureteral reflux. 8 of the patients had at least two UTI attacks. In total 38 UTI attacks; There were 7 18.4 nitrite positivity. UTI was detected in 15 39.5 patients during the first 3 months after transplantation. While 7 18.4 of the urine cultures were gram positive and 27 71.1 were gram negative bacteria, 4 10.5 were found as contamination. Escherichia coli 34.2 was the most common causative agent, followed by Klebsiella pneumoniae 21.1, Enterococcus faecium 18.4, Pseudomonas aeruginosa 5.3 and other gram negative . 10.5 uropathogens were found to be followed. When compared with basal and UTI GFR glomerular filtration rate levels, the GFR values detected during UTI were decreased significantly p0.00. The most frequently preferred antibiotics in UTI treatment were ertapenem 42.1, levofloxacin 10.5, seftriaxon 10.5 and fosfomycin 10.5. Conclusion: Improperly treated UTI negatively affects the outcome of transplantation and increases mortality. Therefore, risk factors, antibiotic resistance and empirical treatments should be reviewed and treatment success should be increased.

 Introduction: After renal transplantation, urinary tract infection UTI is observed in 23-75 of cases. In this study, we aimed to investigate the incidence of UTIs after renal transplantation, the causative pathogens and the predisposing factors that increase the risk. Methodology: Patients who underwent renal transplantation in our hospital between 2016-2017 were included in the study. Results: Twenty-five patients who underwent kidney transplantation were included in the study. UTI was detected in 12 patients 48. One patient had neurogenic bladder, three had nephrolithiasis and one had vesicoureteral reflux. 8 of the patients had at least two UTI attacks. In total 38 UTI attacks; There were 7 18.4 nitrite positivity. UTI was detected in 15 39.5 patients during the first 3 months after transplantation. While 7 18.4 of the urine cultures were gram positive and 27 71.1 were gram negative bacteria, 4 10.5 were found as contamination. Escherichia coli 34.2 was the most common causative agent, followed by Klebsiella pneumoniae 21.1, Enterococcus faecium 18.4, Pseudomonas aeruginosa 5.3 and other gram negative . 10.5 uropathogens were found to be followed. When compared with basal and UTI GFR glomerular filtration rate levels, the GFR values detected during UTI were decreased significantly p0.00. The most frequently preferred antibiotics in UTI treatment were ertapenem 42.1, levofloxacin 10.5, seftriaxon 10.5 and fosfomycin 10.5. Conclusion: Improperly treated UTI negatively affects the outcome of transplantation and increases mortality. Therefore, risk factors, antibiotic resistance and empirical treatments should be reviewed and treatment success should be increased.

 Introduction: After renal transplantation, urinary tract infection UTI is observed in 23-75 of cases. In this study, we aimed to investigate the incidence of UTIs after renal transplantation, the causative pathogens and the predisposing factors that increase the risk. Methodology: Patients who underwent renal transplantation in our hospital between 2016-2017 were included in the study. Results: Twenty-five patients who underwent kidney transplantation were included in the study. UTI was detected in 12 patients 48. One patient had neurogenic bladder, three had nephrolithiasis and one had vesicoureteral reflux. 8 of the patients had at least two UTI attacks. In total 38 UTI attacks; There were 7 18.4 nitrite positivity. UTI was detected in 15 39.5 patients during the first 3 months after transplantation. While 7 18.4 of the urine cultures were gram positive and 27 71.1 were gram negative bacteria, 4 10.5 were found as contamination. Escherichia coli 34.2 was the most common causative agent, followed by Klebsiella pneumoniae 21.1, Enterococcus faecium 18.4, Pseudomonas aeruginosa 5.3 and other gram negative . 10.5 uropathogens were found to be followed. When compared with basal and UTI GFR glomerular filtration rate levels, the GFR values detected during UTI were decreased significantly p0.00. The most frequently preferred antibiotics in UTI treatment were ertapenem 42.1, levofloxacin 10.5, seftriaxon 10.5 and fosfomycin 10.5. Conclusion: Improperly treated UTI negatively affects the outcome of transplantation and increases mortality. Therefore, risk factors, antibiotic resistance and empirical treatments should be reviewed and treatment success should be increased.

 Giriş: Renal transplantasyon sonrası, 23-75 oranında üriner sistem enfeksiyonu ÜSE görülmektedir. Bu çalışmada böbrek nakli sonrası ÜSE sıklığı, neden olan patojenler ve riski artıran predispozan faktörlerin araştırılması amaçlanmıştır. Hastalar ve metod: 2016-2017 yılları arasında hastanemizde renal transplant yapılan hastalar çalışmaya dahil edildi. Postoperatif immunsupresif tedavileri; basiliksimab, mikofenolat mofetil, takrolimus ve prednizolon kombinasyonundan oluştu. Perioperatif antibiyotik profilaksisinde bir hastada klindamisin, diğerlerinde sefuroksim aksetil kullanıldı. Tüm hastalara üriner kateterizasyon ve anastomoz esnasında double- J stend kullanıldı. Hastalara postoperatif dönemde 6 ay boyunca Pneumocystis jirovecii profilaksisi için trimetoprim sulfametaksazol TMP-SXT verildi. Bulgular: Böbrek transplantasyonu yapılan 25 hasta çalışmaya dahil edildi. On iki hastada 48 ÜSE saptandı. Bir hastada nörojenik mesane, üçünde nefrolitiyazis ve birinde vezikoüreteral reflü mevcuttu. Hastaların 8inde en az iki ÜSE atağı mevcuttu. Toplam 38 ÜSE atağında; 7 18,4 nitrit pozitifliği saptandı. 15inde 39,5 transplantasyon sonrası ilk 3 ay içerisinde ÜSE saptandı. İdrar kültürlerinin 7sinde 18,4 gram pozitif, 27sinde 71,1 gram negatif bakteri üremesi olurken, 4ü 10,5 kontaminasyon olarak bulundu. Üreyen etkenler arasında Escherichia coli 34,2 ilk sırada yer alırken, bunu sırasıyla Klebsiella pneumoniae 21,1, Enterococcus faecium 18,4, Pseudomonas aeruginosa 5,3 ve diğer gram negatif 10,5 üropatojenlerin izlediği bulundu. ÜSE öncesi bazal ve ÜSE sırasındaki GFR glomerüler filtrasyon hızı düzeyleri karşılaştırıldığında ÜSE sırasında saptanan GFR değerlerinin öncesine göre anlamlı derecede azaldığı saptandı p0.00 ÜSE tedavisinde en sık tercih edilen antibiyotikler ertapenem 42,1, levofloksasin 10,5, seftriakson 10,5 ve fosfomisin 10,5 idi. Sonuç: Transplant alıcılarında profilaksi ve tedavi amaçlı antibiyotiklerin kullanımına bağlı üropatojenlerin direnç oranları artmaktadır. Uygunsuz tedavi edilen ÜSE, transplantasyonun sonucunu olumsuz etkilemekte ve mortaliteyi arttırmaktadır. Bu yüzden hastaların risk faktörleri, antibiyotik dirençleri, ampirik tedaviler gözden geçirilmeli ve tedavi başarısının arttırılması sağlanmalıdır.

Makale detayları

Evaluation of urinary tract infections in a two-year follow-up after renal transplantation: a single center experience

Yazarlar:

Tugba Sarı | Belda Dursun | Mevlüt Çeri | İlknur Kaleli | Hüseyin Turgut | Murat Özban

Yayıncı:

Pamukkale University

Ana Başlıklar:

Bulaşıcı Hastalıklar

Dergi:

Pamukkale Tıp Dergisi Vol.16 Issue 1, pp.51-57

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001281229

pISSN:

1308-0865

Renal transplantation

transplantation

UTI

transplant

ÜSE

Renal transplant

transplant

ÜSE

Renal transplant, transplant, ÜSE

Sayı

Makale detayları

Yazarlar: Tugba Sarı | Belda Dursun | Mevlüt Çeri | İlknur Kaleli | Hüseyin Turgut | Murat Özban

Yayıncı: Pamukkale University

Ana Başlıklar: Bulaşıcı Hastalıklar

Dergi: Pamukkale Tıp Dergisi Vol.16 Issue 1, pp.51-57

Belge Tipi: Makale

Yayın Tarihi: 1/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001281229

pISSN: 1308-0865

Sayı

Yazarlar:

Tugba Sarı | Belda Dursun | Mevlüt Çeri | İlknur Kaleli | Hüseyin Turgut | Murat Özban

Yayıncı:

Pamukkale University

Ana Başlıklar:

Bulaşıcı Hastalıklar

Dergi:

Pamukkale Tıp Dergisi Vol.16 Issue 1, pp.51-57

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001281229

pISSN:

1308-0865