Almaimani Anas O
Department of Urology, King Abdulaziz Airbase Hospital, Dhahran, SAU.
Cureus. 2021 Jun 17;13(6):e15713. doi: 10.7759/cureus.15713.
Urinary tract infections (UTIs) can commonly occur within the first few weeks following kidney transplantation procedures. Although the management of asymptomatic bacteriuria and acute graft pyelonephritis is important to reduce the risk of graft rejections following kidney transplantation, the efficacy of antibiotics administration remains controversial among studies in the literature. The aim of this review is to elaborate more on asymptomatic bacteriuria following kidney transplantation and try to formulate proper evidence about the efficacy of antibiotics administration on eliminating the frequency of infections and enhancing the quality of care for patients. Most studies in the literature are observational, which are usually biased in the interventions. However, the current evidence regarding the management and screening of asymptomatic bacteriuria seems to discourage such an approach. Almost all of the included studies reported that antibiotic administration did not significantly lower the rates of secondary symptomatic UTIs or enhance the functions of the graft. In addition, there is no significant impact on mortality and other clinical outcomes. Lastly, the frequent administration of antibiotics can significantly increase the risk of recurrence due to the emergence of novel strains of bacteria that are resistant to the currently administered antibiotics making it unfavorable.
尿路感染（UTIs）通常会在肾移植手术后的最初几周内发生。虽然无症状菌尿症和急性移植肾盂肾炎的管理对于降低肾移植后移植排斥反应的风险很重要，但抗生素给药的疗效在文献研究中仍存在争议。本综述的目的是更详细地阐述肾移植后的无症状菌尿症，并尝试就抗生素给药在消除感染频率和提高患者护理质量方面的疗效制定适当的证据。文献中的大多数研究都是观察性的，在干预措施方面通常存在偏差。然而，目前关于无症状菌尿症管理和筛查的证据似乎不支持这种方法。几乎所有纳入的研究都报告称，抗生素给药并没有显著降低继发性症状性UTIs的发生率或增强移植功能。此外，对死亡率和其他临床结果没有显著影响。最后，频繁使用抗生素会显著增加复发风险，因为会出现对当前使用的抗生素耐药的新型细菌菌株，这是不利的。
