Post-renal transplant infections: single-center experience from Nigeria

Infections are the leading cause of hospitalization and mortality in transplant recipients. Nigeria has a growing number of renal transplant recipients. The aim of this study was to determine the pattern of infections in renal allograft recipients in one of the major renal transplant centers in Nigeria.

All case records of renal allograft recipients on follow-up were retrieved. Those that had infection at any time after transplantation were selected. Demographic and clinical information was collected and analyzed.

Thirty-three case records were analyzed, out of which 24/33 (72.7%) were males, with a mean age of 42.3 years (± 7.38). The median duration of developing infection post transplant was 270 days (range 2-2190). Most of the infections occurred after 6 months in 15/33 (45.5%). Urinary tract infection was the most common infection, noted in 13/33 (39.4%), followed by pneumonia, which was seen in 12 (33.3%), 9/12 (75%) of which were culture-positive. There were 2 cases (5.6%) of tuberculosis and 1 case (2.8%) of cytomegalovirus colitis. Out of the 9 culture-positive pneumonia cases, 6 (66.7%) were caused by gram-negative pathogens, with Pseudomonas aeruginosa being the most common isolate seen in 3/9 (33.3%) of the patients. Among those with urinary tract infection, Escherichia coli and Klebsiella species were isolated with equal proportion in 3/13 (23.1%), while Enterococcus faecalis was the most common isolate in 4/13 (30.8%). Overall infection-related mortality was 10/33 (30.3%), out of which 5/10 (50%) of deaths were from pneumonia.

Post-transplant infection surveillance must be strengthened. The role of multidrug-resistant gram-negative bacteria in post-renal transplant infection in Nigeria needs to be evaluated.