Moradi Mahmoudreza, Abbasi Mohammadreza, Moradi As'ad, Boskabadi Ali, Jalali Amir
Urology and Nephrology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Urol J. 2005 Winter;2(1):32-5.
Asymptomatic bacteriuria is a very common complication after kidney transplantation and the need for antibiotic therapy is controversial. The aim of this study was to evaluate the effect of antibiotic therapy on the clinical course of asymptomatic bacteriuria in renal transplant recipients.
In the present study, 88 kidney transplant recipients with asymptomatic bacteriuria were divided into two groups of cases and controls. The patients had been selected from among those with at least 1 year follow-up. In the case group, asymptomatic bacteriuric episodes were treated with antibiotics, and in control group, they were followed without antibiotic therapy. The follow-up period was 9 to 12 months. Bacteriuric episodes, symptomatic urinary tract infection (UTI) episodes, and changes in plasma creatinine level were recorded and compared between the two groups.
The rate of bacteriuric episodes and symptomatic UTIs were not significantly different between the two groups (P >0.05). In addition, level of plasma creatinine did not increase significantly in neither of the groups during the study (P >0.05).
It seems that treatment of asymptomatic bacteriuria in kidney recipients does not decrease the rate of UTI episodes afterwards. Asymptomatic bacteriuria does not affect renal function in short term. Thus, we can abandon antibiotic therapy, subject to careful follow-up.
无症状菌尿是肾移植术后一种非常常见的并发症,抗生素治疗的必要性存在争议。本研究的目的是评估抗生素治疗对肾移植受者无症状菌尿临床病程的影响。
在本研究中,88例无症状菌尿的肾移植受者被分为病例组和对照组。这些患者选自至少有1年随访期的人群。病例组中,无症状菌尿发作采用抗生素治疗,对照组则不进行抗生素治疗,仅进行随访。随访期为9至12个月。记录并比较两组的菌尿发作、有症状的尿路感染(UTI)发作以及血浆肌酐水平的变化。
两组的菌尿发作率和有症状的UTI发作率无显著差异(P>0.05)。此外,在研究期间两组的血浆肌酐水平均未显著升高(P>0.05)。
肾移植受者无症状菌尿的治疗似乎不会降低随后的UTI发作率。无症状菌尿在短期内不影响肾功能。因此,在仔细随访的情况下,我们可以放弃抗生素治疗。