Urinary tract infection in renal allograft recipients

A retrospective analysis of urinary tract infection (UTI) in renal allograft recipients (190 males and 38 females) being followed-up at our institute is reported. UTI accounted for 32.8% of infectious episodes (85/259). Patients who received unrelated allografts (transplanted elsewhere) had significantly more episodes of UTI beyond three months than patients with live related allografts (p=0.003). Patients with diabetic nephropathy had a higher incidence of recurrent UTI (5/18 vs 17/210) (p=0.02). Of the 12 patients with pre-transplant UTI, six developed UTI in the post-transplant period (p=0.048), In five of these patients the same organism was responsible for the UTI. Patients with urological complications had a higher incidence of UTI (19/46 vs 32/182, p=0.001), UTI was more common in patients with urinary leaks (11/19), ureteral obstruction (1/1) and perinephric hematoma (3/3), Patients catheterized for more than seven days had a higher incidence of UTI (9/20 vs 42/208, p=0.02), In the first three months post-transplant there were 57 episodes (67.0%), followed by 15 episodes (17.6%) in the period between three months and one year and 13 episodes (15.4%) beyond one year, Non-E. coli UTI predominated throughout the post-transplant period (71.2%), The factors predisposing to a significantly increased risk of UTI in our study were (i) history of UTI in the pre-transplant period; (ii) occurrence of urological complications, and (iii) prolonged catheterization.