Generic placeholder image

Current Drug Therapy

Editor-in-Chief

ISSN (Print): 1574-8855
ISSN (Online): 2212-3903

Research Article

Investigation of Nosocomial Urinary Tract Infections Post Transplantation, Main Pathogens, and Sensitivity Tests

Author(s): Zahra Tolou Ghamari*

Volume 19, Issue 7, 2024

Published on: 28 November, 2023

Page: [846 - 850] Pages: 5

DOI: 10.2174/0115748855271275231115064229

Price: $65

Abstract

Background: Regarding end-stage organ disease, transplantation is recommended as the best therapeutic management. After organ transplantation, the incidence of nosocomial urinary tract infections (NUTIs) due to multidrug-resistant Gram-negative bacilli increases.

Aim: The study aimed to investigate NUTIs post-transplantation, the main pathogens involved, and sensitivity tests conducted in a tertiary hospital in Isfahan, Iran.

Methods: A retrospective survey on patients admitted to a tertiary hospital in Isfahan (Alzahra), Iran, was performed between 27 March, 2017, and 9 February, 2022. The information recorded included the date of infection, date of hospitalization, gender, age, type of pathogens, and resistance or sensitivity to antibiotics.

Results: 73 kidney transplant recipients (61% females) with a mean age of 43. 2 ± 15.1 years were included. Within this population involving both genders, the main pathogens involved in NUTIs were as follows: Escherichia coli (30%), Klebsiella pneumonia (19%), Candida albicans and non-albicans (14%), Enterococcus faecalis (12%), Enterobacteriaceae (8%), Pseudomonas aeruginosa (6%), Staphylococcus spp. (6%), Acinetobacter baumannii (4%), and Streptococcus spp. (4%). Antibiotic susceptibility testing showed the most sensitivity of isolates against amikacin (n=29; 66%), meropenem (n= 28; 64%), piperacillin/tazobactam (n=26; 54%), cefepime (n= 25; 40%), ceftazidime (n= 27; 30%), ciprofloxacin (n= 40; 18%), and co-trimoxazole (n= 29; 10%).

Conclusion: Escherichia coli, Klebsiella pneumonia, and Candida spp. were the major causes of NUTIs within the studied organ-transplanted recipients. Amikacin, meropenem, and piperacillin/ tazobactam have shown more than 50% sensitivity against isolates. Further evidence-based pharmacotherapy investigations associated with the different spectrum antibiotics and overall antimicrobial success rate is recommended to be advantageous.

[1]
Azegami T, Kounoue N, Sofue T, et al. Efficacy of pre-emptive kidney transplantation for adults with end-stage kidney disease: a systematic review and meta-analysis. Ren Fail 2023; 45(1): 2169618.
[http://dx.doi.org/10.1080/0886022X.2023.2169618] [PMID: 36705051]
[2]
Kennedy A, Rice MK, Waguespack M, Xie WY, Al-Qaoud T, Malik RD. A contemporary evaluation of urological outcomes after renal transplantation. Urol Pract 2023; 10(1): 75-81.
[http://dx.doi.org/10.1097/UPJ.0000000000000353] [PMID: 37103439]
[3]
Suárez Fernández ML, Ridao Cano N, Álvarez Santamarta L, Gago Fraile M, Blake O, Díaz Corte C. A current review of the etiology, clinical features, and diagnosis of urinary tract infection in renal transplant patients. Diagnostics (Basel) 2021; 11(8): 1456.
[http://dx.doi.org/10.3390/diagnostics11081456] [PMID: 34441390]
[4]
Velioglu A, Guneri G, Arikan H, et al. Incidence and risk factors for urinary tract infections in the first year after renal transplantation. PLoS One 2021; 16(5): e0251036.
[http://dx.doi.org/10.1371/journal.pone.0251036] [PMID: 33939755]
[5]
Tadayon F, Shariati A, Tolou-Ghamari Z. Type of vascular anastomosis and early outcome after kidney transplantation. Urologiia 2021; (3): 75-81.
[PMID: 34251105]
[6]
Tolou-Ghamari Z, Mortazavi M, Palizban AA, Najafi MR. The investigation of correlation between Iminoral concentration and neurotoxic levels after kidney transplantation. Adv Biomed Res 2015; 4: 59.
[http://dx.doi.org/10.4103/2277-9175.151876]
[7]
Tolou-Ghamari Z, Palizban A, Gharavi M. Cyclosporin trough concentration-rejection relationship after kidney transplantation. Indian J Pharmacol 2003; 35(6): 395-6.
[8]
Tolou-Ghamari Z, Sanei B. Prograf Concentrations in Liver Transplantation: Correlation with Headache and Other Neurotoxic Complications? Thrita 2016; 5(1)
[9]
Lys Z, Dombrovská K, Dědochová J, Kovářová P, Valkovský I, Václavík J. Acute infections in kidney transplant recipients 2022.
[http://dx.doi.org/10.36290/vnl.2022.041]
[10]
Arabi Z, Al Thiab K, Altheaby A, et al. Urinary tract infections in the first 6 months after renal transplantation. Int J Nephrol 2021; 2021: 1-8.
[http://dx.doi.org/10.1155/2021/3033276] [PMID: 34820141]
[11]
Halskov ACL, Dagnæs-Hansen J, Stroomberg HV, Sørensen SS, Røder A. Incidence of and risk factors for recurrent urinary tract infections in renal transplant recipients. European Urology Open Science 2023; 52: 115-22.
[http://dx.doi.org/10.1016/j.euros.2023.04.001] [PMID: 37284043]
[12]
Abdo-Cuza AA, Gómez-Bravo MA, Pérez-Bernal JB, et al. Health care–associated infection in solid organ transplant recipients. Transplant Proc 2020; 52(2): 509-11.
[http://dx.doi.org/10.1016/j.transproceed.2019.12.010] [PMID: 32035674]
[13]
Abu S, Asaolu SO, Igbokwe MC, et al. Bacterial colonization in double J stent and bacteriuria in post-renal transplant patients. Cureus 2022; 14(7): e27508.
[http://dx.doi.org/10.7759/cureus.27508] [PMID: 36060333]
[14]
El Hennawy H, Safar O, Al Faifi AS, et al. Recurrent urinary tract infection in living donor renal transplant recipients and the role of behavioral education program in management: A single-center experience. Transplant Proc 2023; 55(1): 103-8.
[http://dx.doi.org/10.1016/j.transproceed.2022.09.032] [PMID: 36577635]
[15]
Ito K, Goto N, Futamura K, et al. Death and kidney allograft dysfunction after bacteremia. Clin Exp Nephrol 2016; 20(2): 309-15.
[http://dx.doi.org/10.1007/s10157-015-1155-6] [PMID: 26307127]
[16]
Cases-Corona C, Shabaka A, Gonzalez-Lopez A, et al. Fulminant emphysematous pyelonephritis by Candida glabrata in a kidney allograft. Nephron J 2020; 144(6): 304-9.
[http://dx.doi.org/10.1159/000507259] [PMID: 32344404]
[17]
Yuan X, Liu T, Wu D, Wan Q. Epidemiology, susceptibility, and risk factors for acquisition of MDR/XDR Gram-negative bacteria among kidney transplant recipients with urinary tract infections. Infect Drug Resist 2018; 11: 707-15.
[http://dx.doi.org/10.2147/IDR.S163979] [PMID: 29785131]
[18]
Wu D, Huang X, Jia C, Liu J, Wan Q. Clinical manifestation, distribution, and drug resistance of pathogens among abdominal solid organ transplant recipients with klebsiella pneumoniae infections. Transplant Proc 2020; 52(1): 289-94.
[http://dx.doi.org/10.1016/j.transproceed.2019.11.023] [PMID: 31837819]
[19]
Antonio MEE, Cassandra BGC, Emiliano RJD, et al. Treatment of asymptomatic bacteriuria in the first 2 months after kidney transplant: A controlled clinical trial. Transpl Infect Dis 2022; 24(6): e13934.
[http://dx.doi.org/10.1111/tid.13934] [PMID: 35980169]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy