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Impact of Early versus Late Ureteric Stent Removal and Antibiotic Prophylaxis on Urinary Tract Infection Incidence in Kidney Transplant Adult Recipients

K. Althiab1, B. Alqahtani2, R. Alotaibi3, R. Alhussein3, R. Almuhiteb2, L. Alnajjar2, M. Alqahtani2, K. Bin Saad4, W. Ohali4, A. Tamimi4, M. N. Almarastani4, S. Kashkoush4, G. Aboalsameh4, M. Shaheen4, M. Tawhari4, A. Altheaby4, Z. Arabi5

1Pharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh, Saudi Arabia, 2College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia, 3bCollege of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia, 4Organ Transplant Center, King Abdulaziz Medical Center, Riyadh, Saudi Arabia, 5King Abdulaziz Medical Center, Riyadh, Saudi Arabia

Meeting: 2021 American Transplant Congress

Abstract number: 776

Keywords: Infection, Kidney transplantation

Topic: Clinical Science » Infectious Disease » Kidney Infectious Non-Polyoma & Non-Viral Hepatitis

Session Information

Session Name: Kidney Infectious Non-Polyoma & Non-Viral Hepatitis

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: To investigate the impact of early Vs. late ureteric stent removal while utilizing various antibiotic prophylaxis regimens on UTI in renal transplant recipients.

*Methods: A retrospective study of 279 renal transplantation from January 2017 to May 2020 with 6 months follow-up, that was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Patients were divided into two groups: early stent removal group (<3 weeks) or late stent removal group (>3 weeks). Peri-transplant antibiotic prophylaxis included Cefazolin or Ampicillin plus Cefotaxime while the post-transplant included single strength Bactrim or double strength Bactrim plus Norfloxacin.

*Results: Ninety-seven (35%) patients developed UTI (mean age 45.8±16.0 years; 60 [61.9%] women). The mean stent removal time was 15.3±4.8 days in the 1st group and 49.7±25.9 days in the second. Among 114 patients in the 1st group, 32% had UTI Vs 37% of 165 in the second. The rate of UTI before removing the stent was 20% and 80% in the early and late group, respectively. Asymptomatic UTI was observed in 70% and 34% before stent removal in the early and late group, respectively (P=0.037), and in 27% and 33% after stent removal in the early and late group, respectively (P=0.692). No difference in the distribution of multidrug resistant organisms among the early and late groups (47.50% Vs 33.30%, respectively; P=0.205), and before or after stent removal (65.90%% Vs 51.80%, respectively; P=0.213). Predictors for UTI were age > 40 years (odds ratio, 2.028; 95% CI, 1.098-3.745; P=0.024), female gender (odds ratio, 5.165; 95% CI, 2.768-9.636; P<0.001), and type II diabetes (odds ratio, 2.023; 95% CI, 1.003-4.08; P=0.049). Type of post-transplant antibiotic prophylaxis was not a significant predictor for UTI (odds ratio, 1.507; 95% CI, 0.735-3.091; P=0.263).

*Conclusions: Early stent removal is associated with lower rate of UTI without significant effect form the choice of prophylactic antibiotics.

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To cite this abstract in AMA style:

Althiab K, Alqahtani B, Alotaibi R, Alhussein R, Almuhiteb R, Alnajjar L, Alqahtani M, Saad KBin, Ohali W, Tamimi A, Almarastani MN, Kashkoush S, Aboalsameh G, Shaheen M, Tawhari M, Altheaby A, Arabi Z. Impact of Early versus Late Ureteric Stent Removal and Antibiotic Prophylaxis on Urinary Tract Infection Incidence in Kidney Transplant Adult Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-early-versus-late-ureteric-stent-removal-and-antibiotic-prophylaxis-on-urinary-tract-infection-incidence-in-kidney-transplant-adult-recipients/. Accessed May 11, 2025.

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