Urinary Tract Infections in a Cohort of Kidney Transplant Recipients

Abstract

Introduction: Urinary tract infection is the most common infectious complication following renal transplantation and its frequency is insufficiently studied in Portugal. The aim of this study was to characterize the incidence of urinary tract infections and recurrent urinary tract infections in renal transplant recipients.
Material and Methods: This was a retrospective cohort observational study, obtained from clinical files of all patients who received a renal transplant at the Hospital of Santa Cruz, from January 2004 to December 2005, with a mean follow-up period of five years or until date of graft loss, death or loss of follow-up. After a descriptive analysis of the population, we used bivariate tests to identify risk factors for urinary tract infections.
Results: A total of 127 patients were included, with a 593 patients.year follow-up. We detected 53 patients (41.7%) presenting with at least one episode of urinary tract infection; 21 patients (16.5%) had recurrent urinary tract infection. Female gender was the only risk factor associated with the occurrence of urinary tract infections (p < 0.001, OR = 7.08, RR = 2.95) and recurrent urinary tract infections (p < 0.001, OR = 4.66, RR = 2.83). Escherichia coli (51.6%), Klebsiella pneumoniae (15.5%) and Enterobacter spp (9.9%) were the
most frequently identified pathogens. Patients did not reveal an increased mortality or allograft loss. However, urinary tract infections were the most important cause of hospital admissions.
Discussion: Female gender was the only risk factor for urinary tract infections in this population. Escherichia coli was the most frequent agent isolated.
Conclusion: Despite preventive measures, urinary tract infections remain an important cause of morbidity and hospital admissions.
Keywords: Urinary Tract Infections; Postoperative Complications; Risk Factors; Kidney Transplantation; Portugal.