Sharma Manjuri, Qanoongo Faheem Nazir, Doley Prodip Kumar, Pegu Gayatri, Pegu Miranda
Department of Nephrology, Gauhati Medical College, Guwahati, Assam, India.
Int Urol Nephrol. 2025 May 22. doi: 10.1007/s11255-025-04571-6.
Urinary tract infections (UTI) pose a significant threat to renal allograft recipients (RARs), jeopardizing graft function and patient survival. This study aimed to investigate the incidence, microbiological profile, risk factors, and impact of UTI on renal allograft outcomes.
A retrospective cohort study was conducted at a tertiary care center in Assam, India, from July 2022 to January 2024, including 220 RARs aged over 18 years. Detailed clinical, microbiological, and outcome data were collected and analyzed. Multivariate logistic regression was performed to identify independent risk factors.
The incidence of UTI was 55/220, (25%), with a higher incidence in females 32/55 (58%). The highest incidence occurred within the first 3 months post-transplant (42.3%), followed by 4-6 months (34.6%), and beyond 6 months (23.1%). Asymptomatic bacteriuria 25/55 (45%) and cystitis (19/55 (35%) were the most common UTI types. Escherichia coli 22/55 (44%) and Klebsiella pneumoniae 18/55 (32%) were the predominant uropathogens, with 7/55 (12%) of isolates being multi-drug resistant (MDR) and 4/55 (7%) pan-drug resistant (PDR). Female gender [odds ratio (OR) 6.73, 95% confidence interval (CI) 4.53-12.65, p < 0.001)], prolonged Foley's catheterization (OR 3.92, 95% CI 2.95-4.88, p = 0.019), and urinary tract abnormalities (OR 2.83, 95% CI 1.61-4.17, p = 0.027) emerged as significant independent risk factors. UTI led to acute graft dysfunction in 54% (30/55) of cases, and 3% (2/55) underwent graft nephrectomy. However, 76% (23/30) of patients with acute graft dysfunction due to UTI achieved complete recovery with management.
This study on UTI in renal transplant recipients in India found a 25% incidence rate, highest within the first 3 months post-transplant. Asymptomatic bacteriuria was common, despite UTI-related graft challenges, most acute dysfunctions resolved with management. Female gender, prolonged catheterization, and urinary tract abnormalities were significant risk factors.
尿路感染（UTI）对肾移植受者（RARs）构成重大威胁，危及移植肾功能和患者生存。本研究旨在调查UTI的发病率、微生物学特征、危险因素以及UTI对肾移植结局的影响。
2022年7月至2024年1月在印度阿萨姆邦的一家三级医疗中心进行了一项回顾性队列研究，纳入220名年龄超过18岁的RARs。收集并分析详细的临床、微生物学和结局数据。进行多因素逻辑回归以确定独立危险因素。
UTI的发病率为55/220（25%），女性发病率更高，为32/55（58%）。最高发病率出现在移植后的前3个月内（42.3%），其次是4 - 6个月（34.6%），6个月后（23.1%）。无症状菌尿25/55（45%）和膀胱炎（19/55（35%）是最常见的UTI类型。大肠埃希菌22/55（44%）和肺炎克雷伯菌18/55（32%）是主要的尿路病原体，7/55（12%）的分离株为多重耐药（MDR），4/55（7%）为泛耐药（PDR）。女性[比值比（OR）6.73，95%置信区间（CI）4.53 - 12.65，p < 0.001]、长期留置导尿管（OR 3.92，95% CI 2.95 - 4.88，p = 0.019）和尿路异常（OR 2.83，95% CI 1.61 - 4.17，p = 0.027）是显著的独立危险因素。UTI导致54%（30/55）的病例出现急性移植肾功能障碍，3%（2/55）接受了移植肾切除术。然而，76%（（23/30）因UTI导致急性移植肾功能障碍的患者经治疗后完全康复。
这项关于印度肾移植受者UTI情况的研究发现发病率为25%，在移植后的前3个月内最高。无症状菌尿很常见，尽管UTI给移植带来挑战，但大多数急性功能障碍经治疗后得到缓解。女性、长期导尿和尿路异常是显著的危险因素。
