Parapiboon W, Ingsathit A, Jirasiritham S, Sumethkul V
Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Transplant Proc. 2012 Apr;44(3):734-6. doi: 10.1016/j.transproceed.2012.03.033.
Since the incidence of bacteriuria in kidney transplant recipients varyes according to the study, we examined it among our cases. Our post hoc analysis of data from a single-center, parallel, randomized, controlled, open label study included 90 patients who underwent kidney transplantation at our hospital from April 2010 to January 2011. Patients were randomized to early ureteric stent removal at 8 days versus routine ureteric stent removal at 15 days after kidney transplantation. We identified the incidence of and causative organism for bacteriuria in the early posttransplant period. Seventy-Four patients (58% living donors) participated in this study. The overall incidence of bacteriuria was 56.7% during the first month after kidney transplantation. In patients who had bacteriuria, 48% showed symptomatic urinary tract infection, 40% asymptomatic bacteriuria and 12% urosepsis. The most common organism was Escherichia coli (40%) follow by Klebsiella pneumoniae (19%). The incidence of an ESBL producing organism was 34%. The incidence of bacteriuria was high during the early post-kidney transplant period, requiring increased awareness and surveillance.
由于肾移植受者中菌尿症的发生率因研究而异，我们在自己的病例中对其进行了检查。我们对一项单中心、平行、随机、对照、开放标签研究的数据进行的事后分析纳入了2010年4月至2011年1月在我院接受肾移植的90例患者。患者被随机分为肾移植术后8天早期拔除输尿管支架组和15天常规拔除输尿管支架组。我们确定了移植后早期菌尿症的发生率及致病菌。74例患者（58%为活体供肾者）参与了本研究。肾移植后第一个月菌尿症的总体发生率为56.7%。在有菌尿症的患者中，48%表现为有症状的尿路感染，40%为无症状菌尿，12%为尿脓毒症。最常见的致病菌是大肠埃希菌（40%），其次是肺炎克雷伯菌（19%）。产超广谱β-内酰胺酶（ESBL）菌的发生率为34%。肾移植术后早期菌尿症的发生率较高，需要提高认识并加强监测。
