Wolters H H, Palmes D, Lordugin E, Bahde R, Senninger N, Hölzen J-P, Kebschull L
Department of General and Visceral Surgery, University Clinic Muenster, Muenster, Germany.
Department of General and Visceral Surgery, University Clinic Muenster, Muenster, Germany.
Transplant Proc. 2014 Dec;46(10):3463-5. doi: 10.1016/j.transproceed.2014.04.019.
Urinary tract infections (UTI) are common nosocomial infections in kidney transplant recipients, with limited evidence to guide antibiotic prophylaxis at urinary catheter removal. The aim of our study was to evaluate the effect of short-term antibiotic therapy at the moment of catheter removal after kidney transplantation.
Twenty kidney transplant recipients received 250 mg of ciprofloxacin orally twice daily 1 day before and at the day of the removal of the urinary catheter and were compared with 20 kidney transplant recipients without prophylaxis. UTI was diagnosed by use of urine culture and clinical signs.
All patients were comparable in sex, age, etiology of end-stage renal failure, immunosuppression, donor type, and initial function. After catheter removal at the 6th postoperative day, a rapid rise of UTI in kidney transplant recipients without prophylaxis (n = 12, 60%) was observed, whereas in patients with antibiotic prophylaxis the rate of UTI could be significantly reduced to 20%. Escherichia coli was the most isolated pathogen in the patients with UTI and was detected at the catheter tip in more than 50% of cases. In 2 patients (10%) after antibiotic prophylaxis, a ciprofloxacin-resistant E coli strain was detected.
The use of antibiotic prophylaxis during urinary catheter removal is recommended to prevent UTI in kidney transplant recipients.
尿路感染（UTI）是肾移植受者常见的医院感染，关于在拔除导尿管时进行抗生素预防的证据有限。我们研究的目的是评估肾移植后拔除导尿管时短期抗生素治疗的效果。
20名肾移植受者在拔除导尿管前1天及当天每天口服2次250毫克环丙沙星，与20名未进行预防的肾移植受者进行比较。UTI通过尿培养和临床症状诊断。
所有患者在性别、年龄、终末期肾衰竭病因、免疫抑制、供体类型和初始功能方面具有可比性。术后第6天拔除导尿管后，观察到未进行预防的肾移植受者中UTI迅速上升（n = 12，60%），而进行抗生素预防的患者中UTI发生率可显著降低至20%。大肠杆菌是UTI患者中最常见的分离病原体，在超过50%的病例中在导尿管尖端检测到。在进行抗生素预防的2名患者（10%）中，检测到耐环丙沙星的大肠杆菌菌株。
建议在拔除导尿管期间使用抗生素预防以防止肾移植受者发生UTI。
