Bacteriological urinalysis in patients after renal transplantation

The study consisted of microbiological urinalysis performed in 269 patients after renal transplantation who remained under medical care at the Outpatient Service of the Transplantation Institute in Warsaw. The patients enrolled into the study had undergone renal transplantation 6 to 72 months before urine samples were collected. 304 urinalysis were performed. In the group of 269 patients, 42 individuals had bacteria in their urine what was confirmed in 47 urine cultures. Cases of bacteriuria were divided into 5 groups: 5 cases of symptomatic urinary tract infection (5 individuals--2% of all studied patients), 27 cases of asymptomatic bacteriuria in 22 individuals (8% of all studied patients), 5 cases of insignificant bacteriuria in 5 patients (2%), 10 cases of involuntary urine contamination in 10 cases (4%). Eventually, urinary tract infection (UTI) was established in 27 patients (5 cases of symptomatic UTI and 22 cases of asymptomatic UTI) what makes out for 10% of all studied patients. In cases where urinalysis showed significant bacteriuria, following pathogens were detected in urine cultures: Escherichia coli: 22 strains, Enterococcus faecalis--4 strains, Enterobacter cloacae--2 strains and 1 strains of Ralstonia picketii, Streptococcus uberis, Pseudomonas aeruginosa and Proteus mirabilis. Over 90% of Gram-negative bacteria were susceptible to ceftriaxone and ceftazidime, as well as to amikacin and aztreonam which are the drugs usually administered intravenously in hospitalized patients. The only drug of similar efficacy, which could be administered orally in outpatients was fosfomycin.