Mueller Thomas, Resinger Christoph, Ruffingshofer Dagmar, Arbeiter Klaus, Balzar Egon, Aufricht Christoph
Universitätsklinik für Kinder- und Jugendheilkunde, AKH Wien, Vienna, Austria.
Wien Klin Wochenschr. 2003 Jun 24;115(11):385-8. doi: 10.1007/BF03040357.
Urinary tract infection is a frequent bacterial complication after renal transplantation in adults and children, however there are only very limited data on children beyond the early post-transplant period. In this study we investigated urinary tract infections in pediatric outpatients who had received transplants more than six months previously. Incidence, risk factors and impact on short-term graft function were analyzed.
47 children who had received a total of 58 allografts were analyzed between 1997 and 2000. At the time of analysis they had had their transplants for an average of 3.5 years (range 0.5-9.4). Urinary tract infection was defined as the presence of both significant bacteriuria (> 10(5) CFU/ml) and symptoms.
Of the 47 patients, 15 (32%) had from 1 to 7 urinary tract infections each. In total 35 infections were recorded. Median age at urinary tract infection was 5.5 years (range 1.8-24.2). Gender, donor source, immunosuppression and underlying disease (urologic vs non-urologic) did not influence the incidence of urinary tract infection. Creatinine but not C-reactive protein rose significantly during the infection.
Our data suggest that urinary tract infection remains a frequent but mostly benign complication in the pediatric transplant population, even beyond the early post-transplant period. More extended studies are needed to assess the long-term effects on graft function.
尿路感染是成人和儿童肾移植后常见的细菌并发症，然而，关于移植后早期以外儿童的相关数据非常有限。在本研究中，我们调查了移植超过6个月的儿科门诊患者的尿路感染情况。分析了发病率、危险因素及其对短期移植肾功能的影响。
对1997年至2000年间共接受58次同种异体移植的47名儿童进行分析。在分析时，他们移植后的平均时间为3.5年（范围0.5 - 9.4年）。尿路感染定义为存在显著菌尿（>10⁵CFU/ml）且伴有症状。
47例患者中，15例（32%）每人发生1至7次尿路感染。共记录到35次感染。尿路感染的中位年龄为5.5岁（范围1.8 - 24.2岁）。性别、供体来源、免疫抑制和基础疾病（泌尿系统与非泌尿系统）均不影响尿路感染的发生率。感染期间肌酐显著升高，而C反应蛋白未升高。
我们的数据表明，即使在移植后早期以外，尿路感染在儿科移植人群中仍然是一种常见但大多为良性的并发症。需要进行更广泛的研究来评估其对移植肾功能的长期影响。
