Urinary tract infections in the first year after renal transplantation
Introduction: Urinary tract infections (UTI) are the most frequent infection in kidney transplant (KT) patients. The main objective was to determine the clinical and microbiological characteristics of UTIs that occur during the first year after KT. Methods: Retrospective cohort study that included p...
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2023
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/41244 |
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I10-R327-article-41244 |
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Universidad Nacional de Córdoba |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
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Artículo revista |
| topic |
kidney transplantation. urinary tract infections infections immunocompromised host Nephrology Infections Urinary tract infections Immunosuppression renal transplant trasplante de riñón infecciones urinarias infecciones huésped inmunocomprometido Nefrologia Infecciones Infecciones urinarias Inmunosuprimido Trasplante renal infecções hospedeiro imunocomprometido transplante de rim infecções urinárias Nefrologia infecções infecções do trato urinário imunossuprimido Transplante de rim |
| spellingShingle |
kidney transplantation. urinary tract infections infections immunocompromised host Nephrology Infections Urinary tract infections Immunosuppression renal transplant trasplante de riñón infecciones urinarias infecciones huésped inmunocomprometido Nefrologia Infecciones Infecciones urinarias Inmunosuprimido Trasplante renal infecções hospedeiro imunocomprometido transplante de rim infecções urinárias Nefrologia infecções infecções do trato urinário imunossuprimido Transplante de rim Vilella, Paula Maldonado, Juan Pablo Fernández, Pehuen Flores, María Fernanda De Bernardi, Camila Vilte Velazquez, Karen Y Hernández, Daniela De La Fuente, Jorge Luis Saad, Emanuel José Urinary tract infections in the first year after renal transplantation |
| topic_facet |
kidney transplantation. urinary tract infections infections immunocompromised host Nephrology Infections Urinary tract infections Immunosuppression renal transplant trasplante de riñón infecciones urinarias infecciones huésped inmunocomprometido Nefrologia Infecciones Infecciones urinarias Inmunosuprimido Trasplante renal infecções hospedeiro imunocomprometido transplante de rim infecções urinárias Nefrologia infecções infecções do trato urinário imunossuprimido Transplante de rim |
| author |
Vilella, Paula Maldonado, Juan Pablo Fernández, Pehuen Flores, María Fernanda De Bernardi, Camila Vilte Velazquez, Karen Y Hernández, Daniela De La Fuente, Jorge Luis Saad, Emanuel José |
| author_facet |
Vilella, Paula Maldonado, Juan Pablo Fernández, Pehuen Flores, María Fernanda De Bernardi, Camila Vilte Velazquez, Karen Y Hernández, Daniela De La Fuente, Jorge Luis Saad, Emanuel José |
| author_sort |
Vilella, Paula |
| title |
Urinary tract infections in the first year after renal transplantation |
| title_short |
Urinary tract infections in the first year after renal transplantation |
| title_full |
Urinary tract infections in the first year after renal transplantation |
| title_fullStr |
Urinary tract infections in the first year after renal transplantation |
| title_full_unstemmed |
Urinary tract infections in the first year after renal transplantation |
| title_sort |
urinary tract infections in the first year after renal transplantation |
| description |
Introduction: Urinary tract infections (UTI) are the most frequent infection in kidney transplant (KT) patients. The main objective was to determine the clinical and microbiological characteristics of UTIs that occur during the first year after KT.
Methods: Retrospective cohort study that included patients over 18 years of age who received KT between 2009-2020 in two hospitals in Córdoba city, Argentina. Patients were followed up during the first year after the transplant by recording them in the medical records, and those who presented at least one episode of UTI were analyzed.
Results: During the study period, 568 KTs were performed, of which 207 (36.4%) had at least one episode of UTI. In total, there were 419 UTI episodes, 6 (1.4%) polymicrobial UTI episodes, so a total of 426 microorganisms were identified in the urine cultures. Of the total number of episodes, 206 (49.2%) occurred between 31 and 180 days post-transplant. The main etiological agent was E. coli with 225 isolates (52.8%) followed by Klebsiella sp. with 94 (22.1%). 52.1% of all episodes were caused by multi-resistant microorganisms (MRM). Among the E. coli isolates, 94 (41.8%) were MRM. The main risk factor associated with UTI due to MRM was a history of recurrent UTIs (RR=1.62; 95%CI=1.29-2.02; p<0.001) and the only protective factor was the use of basiliximab as induction (RR=0.78; 95%CI=0.64-0.94; p=0.012).
Main conclusion: UTIs occurred in more than a third of kidney transplant patients, being slightly more than half caused by MMR. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2023 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/41244 |
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I10-R327-article-412442024-04-24T19:04:13Z Urinary tract infections in the first year after renal transplantation Infecciones urinarias en el primer año postrasplante renal Infecções do trato urinário no primeiro ano após transplante renal Vilella, Paula Maldonado, Juan Pablo Fernández, Pehuen Flores, María Fernanda De Bernardi, Camila Vilte Velazquez, Karen Y Hernández, Daniela De La Fuente, Jorge Luis Saad, Emanuel José kidney transplantation. urinary tract infections infections immunocompromised host Nephrology Infections Urinary tract infections Immunosuppression renal transplant trasplante de riñón infecciones urinarias infecciones huésped inmunocomprometido Nefrologia Infecciones Infecciones urinarias Inmunosuprimido Trasplante renal infecções hospedeiro imunocomprometido transplante de rim infecções urinárias Nefrologia infecções infecções do trato urinário imunossuprimido Transplante de rim Introduction: Urinary tract infections (UTI) are the most frequent infection in kidney transplant (KT) patients. The main objective was to determine the clinical and microbiological characteristics of UTIs that occur during the first year after KT. Methods: Retrospective cohort study that included patients over 18 years of age who received KT between 2009-2020 in two hospitals in Córdoba city, Argentina. Patients were followed up during the first year after the transplant by recording them in the medical records, and those who presented at least one episode of UTI were analyzed. Results: During the study period, 568 KTs were performed, of which 207 (36.4%) had at least one episode of UTI. In total, there were 419 UTI episodes, 6 (1.4%) polymicrobial UTI episodes, so a total of 426 microorganisms were identified in the urine cultures. Of the total number of episodes, 206 (49.2%) occurred between 31 and 180 days post-transplant. The main etiological agent was E. coli with 225 isolates (52.8%) followed by Klebsiella sp. with 94 (22.1%). 52.1% of all episodes were caused by multi-resistant microorganisms (MRM). Among the E. coli isolates, 94 (41.8%) were MRM. The main risk factor associated with UTI due to MRM was a history of recurrent UTIs (RR=1.62; 95%CI=1.29-2.02; p<0.001) and the only protective factor was the use of basiliximab as induction (RR=0.78; 95%CI=0.64-0.94; p=0.012). Main conclusion: UTIs occurred in more than a third of kidney transplant patients, being slightly more than half caused by MMR. Introducción: Las infecciones del tracto urinario (ITU) constituyen la infección más frecuente en los trasplantados renales (TR). El objetivo principal fue determinar las características clínicas y microbiológicas de las ITU que ocurren durante el primer año posterior al TR. Metodología: Estudio de cohorte retrospectivo, donde se incluyeron pacientes mayores 18 años que recibieron un TR entre 2009-2020 en dos hospitales de la ciudad de Córdoba. A través del registro en las historias clínicas se realizó seguimiento de los pacientes durante el primer año postrasplante y se analizaron los que presentaron al menos un episodio de ITU. Resultados: En el período de estudio, se realizaron 568 TR, de los cuales 207(36,4%) tuvieron al menos un episodio de ITU. En total hubo 419 episodios de ITU, 6(1,4%) episodios de ITU polimicrobianos, se identificaron un total de 426 microorganismos en total en los urocultivos. Del total de episodios 206(49,2%) ocurrieron entre los 31-180 días postrasplante. El principal agente etiológico fue E. coli con 225 aislamientos(52,8%) seguido de Klebsiella sp. con 94(22,1%). El 52,1% del total de episodios fueron causados por microorganismos multirresistentes (MMR). Entre los aislamientos de E. coli, 94(41,8%) fueron MMR. El principal factor de riesgo asociado a ITU por MMR fue el antecedente de ITUs recurrentes (RR=1,62; IC95%=1,29-2,02; p<0,001) y el único factor protector fue la utilización de basiliximab como inducción(RR=0,78; IC95%=0,64-0,94; p=0,012) . Conclusión: Las ITU se presentaron en más de un tercio de los pacientes trasplantados renales siendo un poco más de la mitad causados por MMR. Introdução: As infecções do trato urinário (ITUs) são as infecções mais comuns em pacientes transplantados renais (TR). O objetivo principal foi determinar as características clínicas e microbiológicas das ITUs que ocorrem durante o primeiro ano após a TR. Métodos: Estudo de coorte retrospectivo que incluiu pacientes maiores de 18 anos que receberam TR entre 2009 e 2020 em dois hospitais da cidade de Córdoba. Os pacientes foram acompanhados durante o primeiro ano após o transplante por meio de registro em prontuário e analisados aqueles que apresentaram pelo menos um episódio de ITU. Resultados: Durante o período do estudo, foram realizados 568 TRs, dos quais 207 (36,4%) tiveram pelo menos um episódio de ITU. No total, houve 419 episódios de ITU, 6 (1,4%) episódios de ITU polimicrobiana, portanto, um total de 426 microrganismos foram identificados nas culturas de urina. Do total de episódios, 206 (49,2%) ocorreram entre 31 e 180 dias pós-transplante. O principal agente etiológico foi E. coli com 225 isolados (52,8%) seguido de Klebsiella sp. com 94 (22,1%). 52,1% de todos os episódios foram causados por microrganismos multirresistentes (MMR). Entre os isolados de E. coli, 94 (41,8%) eram MMR. O principal fator de risco associado à ITU por MMR foi história de ITUs recorrentes (RR=1,62; IC 95%=1,29-2,02; p<0,001) e o único fator de proteção foi o uso de basiliximabe como indução. (RR=0,78 ; IC95%=0,64-0,94; p=0,012). Conclusão: ITUs ocorreram em mais de um terço dos pacientes transplantados renais, sendo pouco mais da metade causadas por MMR. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-12-26 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Text Texto Texto application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/41244 10.31053/1853.0605.v80.n4.41244 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 No. 4 (2023): Publicaciones especiales por 80° Aniversario; 476-498 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 Núm. 4 (2023): Publicaciones especiales por 80° Aniversario; 476-498 Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 n. 4 (2023): Publicaciones especiales por 80° Aniversario; 476-498 1853-0605 0014-6722 10.31053/1853.0605.v80.n4 spa https://revistas.unc.edu.ar/index.php/med/article/view/41244/44183 https://revistas.unc.edu.ar/index.php/med/article/view/41244/44018 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |