From the Department of Surgery, Division of Transplantation, State University of New York Upstate Medical University, Syracuse, New York, USA.
Exp Clin Transplant. 2023 Jul;21(7):556-561. doi: 10.6002/ect.2023.0057.
Transplant is the gold standard treatment for end-stage renal disease, and yet infectious complications frequently arise in kidney recipients in the context of immunosuppression therapy, with urinary tract infection being the most common. We aimed to assess the prevalence of posttransplant urinary tract infections in kidney transplant recipients and assess the effects on kidney allograft and overall patient outcomes.
We performed a retrospective analysis of data from State University of New York Upstate University Hospital from January 2016 to November 2022 to assess transplant outcomes in patients who underwent a kidney transplant at our center and met the inclusion criteria.
There were 507 renal allograft recipients who met our inclusion criteria and were assessed for the incidence of urinary tract infection within the first year after transplant. Urinary tract infection was recurrent in 113 transplant recipients (55.6%) within the first year, and 118 (58.1%) were on prophylactic antibiotics at urinary tract infection diagnosis. We observed no relation between recurrence of urinary tract infection and use of prophylactic antibiotics (P = .21). Overall allograft survival rate was 92.1% in the urinary tract infection group and 96.7% in the group without urinary tract infection, which was significantly different (P = .02). Urinary tract infection significantly affected allograft survival (hazard ratio, 3.51; 95% CI, 1.49-8.23; P = .004). Overall patient survival rates were 86.7% and 91.4% in the groups with and without urinary tract infection, respectively (P = .08).
We determined that allograft survival was significantly greater in the group without urinary tract infection versus the urinary tract infection group. We found no relation between urinary tract infection recurrence and prophylactic antibiotics. We also found that overall patient survival was not significantly different in the group with urinary tract infection versus the group without urinary tract infection.
移植是治疗终末期肾病的金标准治疗方法，但在免疫抑制治疗的情况下，肾移植受者经常发生感染并发症，尿路感染是最常见的。我们旨在评估肾移植受者移植后尿路感染的患病率，并评估其对肾移植和整体患者结局的影响。
我们对 2016 年 1 月至 2022 年 11 月纽约州立大学上州医科大学医院的数据进行了回顾性分析，以评估在我们中心接受肾移植并符合纳入标准的患者的移植结局。
共有 507 例符合纳入标准的肾移植受者接受评估，以确定移植后 1 年内尿路感染的发生率。在移植后 1 年内，113 例（55.6%）移植受者发生尿路感染复发，118 例（58.1%）在尿路感染诊断时使用预防性抗生素。我们观察到尿路感染复发与预防性抗生素使用之间没有关系（P =.21）。尿路感染组的总体移植物存活率为 92.1%，无尿路感染组为 96.7%，差异显著（P =.02）。尿路感染显著影响移植物存活率（风险比，3.51；95%CI，1.49-8.23；P =.004）。有尿路感染组和无尿路感染组的患者总体存活率分别为 86.7%和 91.4%（P =.08）。
我们确定无尿路感染组的移植物存活率明显大于尿路感染组。我们发现尿路感染复发与预防性抗生素之间没有关系。我们还发现，有尿路感染组和无尿路感染组的患者总体存活率没有显著差异。
