Association of Double-J Stenting in Renal Transplant Patients With Urinary Tract Colonization and Infections in a...

Area of Science:

• Nephrology
• Transplantation Immunology
• Infectious Diseases

Background:

• Kidney transplantation recipients are susceptible to urinary tract infections (UTIs).
• Hospitals endemic for multidrug-resistant (MDR) Gram-negative Enterobacteriaceae pose unique challenges.
• The role of ureteral stenting in post-transplant UTI development in such environments is unclear.

Purpose of the Study:

• To investigate the association between ureteral stenting post-kidney transplantation and the incidence of UTIs and/or colonization.
• To assess this association in a hospital setting with high prevalence of MDR Gram-negative Enterobacteriaceae.

Main Methods:

• A cohort of 75 kidney transplant recipients was divided into two groups: 45 without ureteral stenting (Group A) and 30 with stenting (Group B).
• Group A was further divided into subgroups based on the period of transplantation, reflecting changes in MDR Enterobacteriaceae frequency.
• Statistical analysis compared UTI incidence, recurrence, and asymptomatic bacteriuria between groups.

Main Results:

• Patients without ureteral stenting experienced significantly higher rates and numbers of UTIs compared to those with stenting (32/45 vs 9/30, P < .001).
• Recurrent UTIs were more frequent in non-stented patients (16/45 vs 4/30, P < .05), whereas asymptomatic bacteriuria was more common in stented patients (8/45 vs 14/30, P < .05).
• Subgroup analyses did not alter the primary statistical findings.

Conclusions:

• Ureteral stenting after kidney transplantation is not associated with an increased risk of UTIs in this MDR Gram-negative Enterobacteriaceae endemic hospital.
• Stenting may even be associated with a reduced incidence of symptomatic UTIs.
• Asymptomatic bacteriuria warrants consideration in stented patients.