Year: 2018
Type: book-chapter
Abstract: Urinary tract infection (UTI) is the most common infectious complication following kidney transplantation. The incidence in adults is about 20% in the first six months and 50% in the first three years, despite the common use of antibiotic prophylaxis. Risk factors include more intensive immunosuppression (especially the use of depleting induction antibodies and sirolimus), extremes of age, diabetes, prolonged time on dialysis, abnormal or reconstructed lower urinary tract and prolonged use of urinary catheters and stents. Diagnosis may be complicated by other conditions causing urinary symptoms and fever in transplant recipients, as well as immunosuppression masking the typical presentation and lack of symptoms in a denervated kidney. Infection may involve the graft or native kidneys. Typical uropathogens are commonly involved but UTI’s may also be caused by commensal and fastidious bacteria, fungus, mycobacteria and viruses. Some studies suggest post transplant UTI has a negative impact on graft survival and function, although causality has not been established. There is a paucity of prospective controlled data that can guide UTI prophylaxis or therapy in terms of agent or duration although most programs will routinely use prophylaxis for at least six months.
DOI: 10.5680/lhuii000012
Authors: Valerie Huei Li Gan, Daniel A. Shoskes
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W2905904672