Original Articles

Incidence of Recurrent Urinary Tract Infection after Renal Transplantation


Background: The pathologies classified as urinary tract infections (UTI) can have a deleterious effect on patients who have undergone a renal transplantation.  Often recurrent UTIs will occur, leading to high morbidity, failure of the grafting process overall and even death.  The study presented here seeks to expand the knowledge of recurrent UTIs in the context of renal transplantation, what risks recurrent UTIs pose to transplant patients and evaluate possible treatments.Methods: Renal transplantations were performed on 94 patients.   For six months post-surgery the patients were evaluated for the presence of recurrent UTIs.  The criteria for determining a patient as having a UTI was given as finding   more than 103    and 105  pure colonies within one ml of urine for asymptomatic and symptomatic patients, respectively.   The criteria of recurrent UTI was defined as two or more conclusive UTIs within the first six months after the surgery or three more within a year after renal transplantation.Results: Of the 94 hospitalized patients, 29 UTIs were diagnosed (30.8%). The majority of diagnosed UTIs were in female patients (11.15, 73.3% vs.4.15, 26.7%; p-value = 0.003).   Those patients with diabetes mellitus correlated with a better chance of having a UTI (p-value = 0.019; CI = 1.2-12.2). The incidence rate of UTI was 51.7%, female predominant 73.3%. No  other  pathologies  were  shown  to  affect  the  chance  of  developing recurrent UTIs.   Typically Escherichia coli was the bacterium isolated from urine  cultures  (48.3%)  from  those  who  developed  recurrent  UTI.    The isolates tended to possess resistance to TMP / SMX and piperacillin but were susceptible to imipenem.Conclusion:   Recurrent UTIs in renal transplant patients can be mitigated with proper identification of risk factors.

Patel R, Paya CV. Infection in organ-transplant recipients. Clin. Microbial Rev 1997; 10 (1): 86-124.

Fishman MD, Robert H, Rubin MD.Infection in organ-transplant recipients. N Engl J Med 1998; 338 (24): 1741-51.

Breton PN, Malone MJ, 2000.Renal transplantation. In: Tanasho EA, McAnirch JW (Ed). Smith’s general urology, 15 ed. Lange Medical books / Mc Grow Hill,New York; pp. 614-27.

Takai K, Tollemar J, Wilczek HE, et al. Urinary tract infections following renal transplantation. Clin Transplant 1998; 12 (1): 19-23.

Alangaden DJ, Thyagarajan R, Gruber SA, et al. Infectious complications after kidney transplantation: current epidemiology and associated risk factors. Clin Transplant 2006; 20 (4): 401-9.

Ayham H, Munther H, Ann M.Urinary tract infections in renal transplant recipients: a single center study JRMS 2008; 15 (3):12-6.

Kamath NS, John GT, Neelakantan N, et al. Acute graft pyelonephritis following renal transplantation. Transpl Infect Dis 2006; 8 (3): 140-7.

Maraha B, Van Hooff H, Fiolet H, et al. Infection complications and antibiotic use in renal transplant recipients during a 1-year follow- up. Clin Microbiol Infect 2001; 7 (11): 619-25.

Abbot KC, Oliver JD, Hypolite I, et al. Hospitalizations for bacterial septicemia after renal transplantation in the United States. Am J Nephro 2001; 21 (2): 120-7.

Brayman KL, Stephanian E, Matas AJ, et al. Analysis of infections complicayionsoccuring after solid- organ transplantation. Arch Surg 1992; 127 (1): 38-48.

Chuang P, Parikh CR, Langone A.Urinary tract infections after renal transplantation: a retrospective review at two US transplant centers. Clin Transplant 2005; 19 (2): 230-5.

Song JC, Hwang HS, Yoon HE, et al.Endoscopic subureteral polydimethy lsiloxane injection and prevention of recurrent acute graft pyelonephritis. Nephron Clin Pract 2011; 117 (4):385-9.

Dupont PJ, Psimenou E, Lord R, et al. Late recurrent urinary tract infections may produce renal allograft scarring even in the absence of symptoms or vesicoureteric reflux. Transplantation 2007; 84 (3):351-5.

Miranda C, Carazo C, Banon R, et al. Mycoplasma hominis infection in three renal transplant patients. DiagnMicrobiol Infect Dis 1990; 13 (4): 329-31.

Nafar M, Firouzan A, Einollahi B.Milliary Tuberculosis and CMV Infection in a Kidney Recipient. Nephro-Urology Monthly 2009; 1 (2): 153-5.

Ejrnaes K, Sandvang D, Lundgren B, et al. Pulsed-field gel electrophoresis typing of Escherichia coli strains from samples collected before and after pivmecillinam or placebo treatment of uncomplicated community-acquired urinary tract infection in women. J Clin Microbiol 2006; 44 (5): 1776-81.

Rice JC, Peng T, Kuo YE, et al.Renal allograft injury is associated with urinary tract infection caused by Escherichia coli bearing adherence factors. Am J Transplant 2006; 6 (10): 2375-83.

Pinheiro HS, Mituiassu AM, Carminatti M, et al. Urinary tract infection caused by extended- spectrum beta-lactamase-producing bacteria in kidney transplant patients. Transplant Pro 2010; 42 (2): 486-7.

Pelle G, Vimot S, Levy PP, et al.Acute pyelonephritis represents a risk factor impairing long-term kidney graft function. Am J Transplant 2007; 7 (4): 899-907.

Pourmand G, Salem S, Mehrsai A,et al. Infectious complications after kidney transplantation: a single- center experience. Transpl Infect Dis 2007; 9 (4): 302-9.

Rivera-Sanchez R, Delgado-Ochoa D, Flores-Paz RR, et al. Prospective study of urinary tract infection surveillance after kidney transplantation. BMC Infect Dis 2010; 10: 245.

Iqbal T, Naqvi R, Akhter SF.Frequency of urinary tract infection in renal transplant recipients and effect on graft function. J Pak Med Assoc 2010; 60 (10): 826-9.

Dantas SR, Kuboyama RH, Mazzali M, et al. Nosocomial infections in renal transplant patients: risk factors and treatment implications associated with urinary tract and surgical site infections. J Hosp Infect 2006; 63 (2): 117-123.

Sharma KK, Ayyagiri A, Dhole TN, et al. Prevalence of infections in renal transplant recipients of north India. Indian J Pathol Microbiol 2007; 50 (2): 453-7.

Yacoub R, Akl NK. Urinary tract infections and asymptomatic bacteriuria in renal transplant recipients. J Glob Infect Dis 2011; 3 (4): 383-9.

Munoz P. Management of urinary tract infections and lymphocele in renal transplant recipients. Clin Infect Dis 2001; 33 (Suppl 1): S53-7.

Senger SS, Arslan H, Azap OK, et al. Urinary tract infections in renal transplant recipients. Transplant Proc 2007; 39 (4): 1016-7.

Dicocco P, Orlando G, Mazzotta C, et al. Incidance of urinary tract infections caused by germs resistance to antibiotics commonly used often renal transplantation. Transplant Proc 2008; 40 (6): 1881-4.

Chuang P, Parikh CR, Langone A.Urinary tract infections after renal transplantation: a retrospective review at two US transplant centers. Clin Transplant 2005; 19 (2): 230-5.

Trouillhet I, Benito N, Cervera C, et al. Influence of age in renal transplant infections: cases and controls study. Transplantation 2005; 80 (7): 989-92.

Gaston RS, Basadonna G, Gosio FG, et al. Transplantation in the diabetic patient with advanced chronic kidney disease. Am J Kidney Dis 2004; 44 (3): 529.

Abbott KC, Swanson SJ, Richter ER, et al. Late urinary tract infection after renal transplantation in the united states. Am J Kidney Dis 2004; 44 (2): 353-62.

Midtvedt K, Hartmann A, Midtvedt T, et al. Routine perioperative antibiotic prophylaxis in renal transplantation. Nephrol Dial Transplant 1998; 13 (7): 1637-41.

Memikoglu KO, Keven K, Sengul S, et al. Urinary tract infections following renal transplantation: a single-center experience. Transplant Proc 2007; 39 (10): 3131-4.

IssueVol 2 No 1-2 (2013) QRcode
SectionOriginal Articles
Urinary Tract Infections Kidney Transplantation Risk Factors

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Pourmand MR, Keshtvarz M, Talebi M, Mashhadi R. Incidence of Recurrent Urinary Tract Infection after Renal Transplantation. J Med Bacteriol. 2015;2(1-2):27-34.