Urinary tract infection in renal transplant recipients

Abstract

Introduction: Urinary tract infection (UTI) is the commonest bacterial infection occurring in renal transplant recipients, and it is associated with significant morbidity. This study aimed to assess the characteristics of all UTI episodes diagnosed in renal transplant patients who attended regularly for follow up in the nephrology department of National Heart Center, Tripoli, Libya. Methods: Data were collected by retrospective review of patients' medical records. UTI was defined as a urine culture containing more than 105 colonies/ml and pyuria (10 leukocytes /HPF). Results: Out of a total of 112 kidney transplant patients, UTI was diagnosed in 33 patients (29.5%). The mean age of affected patients was 43±20 years with a range of 20-63 years. Most of the episodes (72%) occurred during the first 3 months after transplantation, and 60.6% of affected patients had more than one episode of infection. A larger proportion of females were affected than males (40.8% versus 20.6% respectively, P=0.02). No significant difference was detected in the proportion of affected patients whether the donor was live-unrelated or live-related (32.3% versus 28.4% respectively, P=0.43). The commonest causative microorganism was E. coli (38.7%), followed by klebsiella (25.8%), Staphylococcus (25.8%), and others (9.7%). The commonest drug used for treatment was ciprofloxacin (51.6%), followed by amoxicillin-clavulinic acid (22.6%), meropenem (12.9%), and others (12.9%). Conclusion: The prevalence of UTI in our cohort of patients is similar to that reported by others. The commonest causative agent was E. coli, and ciprofloxacin was the most commonly used drug. Keywords: Kidney transplant recipients; Libya; Urinary tract infections