Renoult E, Aouragh F, Mayeux D, Hestin D, Hubert J, L'Hermite J, Amicabile C, Weber M, Zerrouki-Bellou M, Blech M F
Service de Nephrolgoie, Hôpital Nancy Nancy-Brabois.
Agressologie. 1992;33 Spec No 3:147-50.
The incidence and the predisposal factors of urinary tract infections (UTI) in the first month post-transplant were studied in 255 kidney transplantations (252 patients). UTI episodes were demonstrated in 73.7% of the grafts. The most common organisms were: Escherichia coli (35.8%), Staphylococcus (33.6%), Streptococcus D (11.2%), Klebsiella (5.3%). The infectious episodes were recurrent in 39% of the cases. The majority of the UTIs were asymptomatic but 7% of the infections led to septicaemia. Etiology of end-stage renal disease, pre-graft binephrectomy, asymptomatic vesicoureteral reflux into the patient's own kidneys, type of immunosuppressive treatment, acute tubular necrosis, rejection episodes, urological complications, coexistent other infections were not predisposal factors. Bacteriuria was more frequent in female than in male patients. The incidence of UTI was found to be statistically increased with history of UTI preoperatively (p = 0.039) and the use of ureteral catheter (p = 0.018). Occurrence of UTI was less common when the donor was treated by antibiotics before brain death (p-0.025). These results provide additional support for regular monitoring of urine cultures in the first month post-transplant. They should help to identify means of reduction of this infectious risk.
对255例肾移植手术（252例患者）术后第一个月内尿路感染（UTI）的发病率及易感因素进行了研究。73.7%的移植肾出现了UTI发作。最常见的病原体为：大肠杆菌（35.8%）、葡萄球菌（33.6%）、D群链球菌（11.2%）、克雷伯菌（5.3%）。39%的病例感染发作呈复发性。大多数UTI无症状，但7%的感染导致败血症。终末期肾病的病因、移植前双侧肾切除术、患者自身肾脏无症状性膀胱输尿管反流、免疫抑制治疗类型、急性肾小管坏死、排斥反应、泌尿系统并发症、并存的其他感染均不是易感因素。女性患者菌尿症比男性更常见。发现术前有UTI病史（p = 0.039）和使用输尿管导管（p = 0.018）时，UTI的发病率在统计学上有所增加。供体在脑死亡前接受抗生素治疗时，UTI的发生率较低（p = 0.025）。这些结果为移植后第一个月定期监测尿培养提供了更多支持。它们应有助于确定降低这种感染风险的方法。
