Microbiologic Monitoring of Kidney Transplant Recipients Before Transplant

Drug immunosuppression, traditionally used to minimize autoimmune developments after liver, kidney, heart, and lung transplant, and which requires high doses of corticosteroids, creates favorable conditions for the development of various infectious processes and the existence of pathogens, which can be activated after transplant. This study aimed to investigate the bacterial pathogens in patients before living-donor kidney transplant.

We prospectively investigated 117 clinical samples of 33 patients who were seen during 2015 at the National Scientific Research Center (Astana, Kazakhstan) before living-donor kidney transplant. Clinical samples included sputum samples, swabs from throat and nose, and urine samples. To identify isolates and antibiotic susceptibility, we used the Vitek 2 automated testing system (BioMérieux, Marcy l'Etoile, France).

Our patient group included 22 male and 11 female patients, with median age of 34.7 ± 2.7 years. In the 117 clinical samples, 16 different bacterial species were found. Of 29 urine samples, 7 samples (24.1%) showed significant growth. Of the 94 isolated pathogens, 21 (22%) were coagulase-negative staphylococci, 16 (17%) were Streptococcus pneumoniae, and 11 (11.7%) were Staphylococcus aureus. About 23% of the isolated Streptococcus pneumoniae were resistant to penicillin and 16.2% to third-generation cephalosporins. In patients who received quinolone/fluoroquinolone antibiotics, there was a higher rate of resistance to ciprofloxacin (41.6%). The least effective drug against pneumococci was the macrolide group of antibiotics, especially erythromycin (75% resistance).

Microbiologic monitoring of recipients before living-donor kidney transplant showed a high level of opportunistic pathogens with a high level of antibiotic resistance as a result of this process of preoperative preparation, in which it is necessary to eradicate bacterial infections.