URINARY TRACT INFECTIONS AFTER RENAL TRANSPLANTATION: IS MALE GENDER A
RISK FACTOR FOR RESISTANT AND RECURRENT INFECTIONS?
Abstract
Background: The most common infections among renal transplant patients
are urinary tract infections (UTI). Our main objective in this study is
to determine the incidence of UTIs in patients who have undergone renal
transplantation in our hospital, to identify the causative
microbiological agents, risk factors and determine the effects of UTI on
short-term graft survival. Methods: Adult patients, who underwent renal
transplantation between October 2011 and July 2018, were included in
this study. Urinary tract infections which developed within the first
year of renal transplantation were investigated. Patients were compared
regarding demographic, clinical, laboratory characteristics, and graft
survival. Results: 102 patients were included in our study. Forty
patients (51.9%) were male and 37 (48.1%) were female. Sixty-seven
urinary tract infection attacks in 21 patients were recorded. Age
(p=0.009; 95% Confidence Interval [CI]: 1.014-1.105), longer
indwelling urinary catheter stay time (p=0.027; 95% Confidence Interval
[CI]: 1.010-1.174) and urologic complications (p=0.032; 95%
Confidence Interval [CI]: 0.094-0.896) were found as risk factors
for UTI development in the first year of transplantation. Escherichia
coli and Klebsiella pneumoniae were the most frequently isolated
microorganisms. Of these bacteria, 63.2 % were found to be extended
spectrum beta lactamase (ESBL) positive. Resistant microorganisms were
more frequent in male patients (31 episodes in males vs. 12 episodes in
females, p=0.0015). UTI had no negative impact on short-term graft
survival. Conclusion: Patients with advanced age, who had a longer
duration of bladder catheterization and urologic complications should be
followed carefully regarding UTI. Since there is a high incidence of UTI
in male transplant patients, more frequently caused by resistant
microorganisms, infection control methods should be applied more
vigorously especially in male transplant patients.