Clinical characteristics and pathogens of recurrent urinary tract infection after renal transplantation
10.3760/cma.j.issn.0254-1785.2018.10.003
- VernacularTitle:肾移植后反复泌尿系统感染的临床特征和病原学特点
- Author:
Yunxia CHEN
1
;
Li GU
;
Xiaopeng HU
;
Xiaodong ZHANG
;
Ran LI
;
Yongzhe LIU
;
Kaiyi XU
;
Renwen ZHANG
Author Information
1. 100020,首都医科大学附属北京朝阳医院感染和临床微生物科
- Keywords:
Kidney transplantation;
Genitourinary system infection;
Antibiotic
- From:
Chinese Journal of Organ Transplantation
2018;39(10):586-591
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics and the pathogens of recurrent urinary tract infection (RUTI) after renal transplantation.Methods The data of adult recipients with UTI from November 2011 to December 2016 were retrospectively analyzed.The recipients were divided into single UTI (SUTI) group and RUTI group.The clinical characteristics and pathogens were analyzed,and the independent risk factors of RUTI were analyzed using logistic regressionmodel.Results Fifty-three cases were selected,including 29 cases of SUTI and 24 cases of RUTI.The positive rate of blood culture (55％ vs.25％,P =0.042) and the concentration of FK506 in the peri-infection period (11.0 + 3.4 ng/mL vs.8.6 + 3.2 ng/mL,P =0.024) in the RUTI group were significantly higher than that those in the SUTI group at the first UTI.The increased concentration of FK506 in the peri-infection period at the first UTI was an independent risk factor for RUTI (β:0.282,95％ CI:1.026-1.713,P＜0.05).There were 86 infection events in 53 patients,and pathogenic microorganisms were cultured in blood culture and urine culture for 86 times.The positive frequency of culture in the RUTI group was higher than that in the SUTI group,but not significantly.The most common pathogenic microorganisms included Escherichia coli (17 times),pseudomonas aeruginosa (16 times),and Enterococcus (16 times).Conclusion Reduction of the FK506 concentration during the peri-infection period at the first UTI is the key to prevent RUTI after renal transplantation.The empirical antibiotics for RUTI should be sensitive for Escherichia coli (ESBL +)and pseudomonas aeruginosa.
