*Purpose: Urinary tract infections (UTIs) remain the most common type of infectious complication experienced by renal allograft recipients. UTIs in transplant patients most commonly occur in the first year post-transplant, but recurrent episodes can occur due to various reasons. In the general pediatric population, Escherichia coli (E.coli) causes 80-90% of UTIs. The purpose was to review and understand the demographics of pediatric transplant patients who required hospitalization over a four-year time period at one center. UTIs in transplant patients are associated with acute rejection risk, chronic allograft nephropathy, and in some cases, urosepsis.

*Methods: A chart review of 145 pediatric kidney transplant recipients was performed to retrospectively identify a total of 65 individual patients with a total of 191 hospital visits. Patients aged 3 to 21 years of age who are followed at the Indiana University Department of Pediatrics for kidney transplantation were included. Data was recorded for symptoms at presentation, urine lab results, and etiology of the underlying kidney disease that lead to end stage renal disease (ESRD).

*Results: Out of 65 total patients included, 39 had a congenital anomaly of the kidneys and the urinary tracts (CAKUT). Obstructive uropathy was the ESRD etiology for 48% of children with CAKUT. Non-obstructive CAKUT included renal hypo/dysplasia and reflux nephropathy. The patients with CAKUT were younger and more likely to be male. Hospitalized pediatric transplant kidney recipients were diagnosed with UTIs at a rate of 30% for the 191 admissions reviewed. There were no statistical differences in the percentage that experienced UTIs or the number of UTIs per year between pediatric transplant recipients with and without CAKUT. E.coli was only responsible for 23% of the UTIs.

*Conclusions: Among hospital visits for pediatric kidney transplant recipients, diagnosis of UTI occurred in almost one-third of admissions. The risk for UTI hospitalization appears to be similar regardless of ESRD etiology. The microbe profile for UTIs experienced by the transplant patients differed from those noted in UTIs in the general pediatric population, E.coli was less likely to the be the causative organism.

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