Screening for asymptomatic bacteruria at one month after adult kidney transplantation: Clinical factors and...

Area of Science:

• Nephrology
• Transplantation Immunology
• Infectious Diseases

Background:

• Urinary tract infections (UTIs) are a significant cause of morbidity following kidney transplantation (KT).
• Screening for asymptomatic bacteriuria (AB) is beneficial in some populations but underexplored in KT recipients.
• Understanding AB incidence and implications post-KT is crucial for patient management.

Purpose of the Study:

• To review the incidence, clinical features, and implications of asymptomatic bacteriuria (AB) one month after kidney transplantation (KT).
• To identify predictors of AB in the KT population.
• To assess the impact of AB on subsequent hospitalization and graft/patient survival.

Main Methods:

• Retrospective analysis of 171 adult KT patients transplanted between 2005 and 2012.
• Protocol urine cultures were obtained at 1 month post-transplantation.
• Patients were stratified for AB presence and analyzed for demographics, clinical parameters, and outcomes (hospitalization, graft/patient survival).

Main Results:

• 24% of KT recipients (41/171) had AB at 30 days post-transplant; 43.9% involved multiresistant organisms.
• Female sex and deceased donor recipients were independent predictors of 30-day AB.
• AB predicted subsequent hospitalization for symptomatic UTI, but 1-year patient and graft survival were similar regardless of AB status.

Conclusions:

• Asymptomatic bacteriuria at 30 days post-KT is predictable in female recipients and those receiving deceased donor kidneys.
• AB is associated with increased morbidity due to subsequent symptomatic UTI hospitalizations.
• Further research into UTI prevention, especially non-antibiotic prophylaxis, is needed for kidney transplant recipients.