Barbouch Samia, Cherif Mejda, Ounissi Mondher, Karoui Cyrine, Mzoughi Sonia, Hamida Fethi Ben, Abderrahim Ezeddine, Bozouita Abdellatif, Abdalla Taiebben, Kheder Adel
Research Laboratory of Immunology-LR03SP01, Charles Nicoles Hospital, Tunis, Tunisia.
Saudi J Kidney Dis Transpl. 2012 Nov;23(6):1311-4. doi: 10.4103/1319-2442.103586.
Urinary tract infection (UTI) is the most frequent infectious complication among renal transplant recipients and a frequent cause of bacteremia, sepsis and acute graft failure. To evaluate the incidence, risk factors, type of pathogens and long-term effect of UTIs on graft and patient survivals in our center, we performed a retrospective cohort study reviewing the medical records of patients who received a renal transplant at our center from June 1986 to December 2009, excluding patients who lost their grafts in the first month due to arterial or veins thrombosis and acute antibody-mediated rejection. We studied 393 kidney-transplanted recipients; at least one UTI occurred in 221 (53.69%) patients during the follow-up period. The most frequent pathogens isolated in urine culture were Escherichia coli (n = 39, 18.4%) and Klebsiella pneumonia (n = 31, 14.6%). When patients with UTIs were compared with those without UTIs, female gender and use of mycophenolate mofetil or azathioprine seemed to be risk factors for UTIs on univariate analysis. However, female gender was the only independent risk factor on multivariate analysis RR = 1.964 (1.202-3.207), P = 0.007. This study confirmed that UTIs remain a major problem in renal transplant recipients, and female gender was the only independent risk factor.
尿路感染(UTI)是肾移植受者中最常见的感染性并发症,也是菌血症、脓毒症和急性移植肾失功的常见原因。为了评估我院中心UTI的发病率、危险因素、病原体类型以及UTI对移植肾和患者生存率的长期影响,我们进行了一项回顾性队列研究,回顾了1986年6月至2009年12月在我院中心接受肾移植患者的病历,排除了因动脉或静脉血栓形成以及急性抗体介导的排斥反应在第一个月内失去移植肾的患者。我们研究了393例肾移植受者;在随访期间,221例(53.69%)患者至少发生了一次UTI。尿培养中分离出的最常见病原体是大肠杆菌(n = 39,18.4%)和肺炎克雷伯菌(n = 31,14.6%)。在单因素分析中,将发生UTI的患者与未发生UTI的患者进行比较时,女性以及使用霉酚酸酯或硫唑嘌呤似乎是UTI的危险因素。然而,在多因素分析中,女性是唯一的独立危险因素,RR = 1.964(1.202 - 3.207),P = 0.007。本研究证实,UTI仍然是肾移植受者中的一个主要问题,女性是唯一的独立危险因素。