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Outcomes of Untreated Asymptomatic Bacteriuria in Renal Transplant Recipients: A Single-Center Experience.

W. Davis, R.-A. Lee, L. Daniels, S. Todd, K. True, P. Chong.

University of North Carolina Medical Center, Chapel Hill, NC.

Meeting: 2016 American Transplant Congress

Abstract number: D108

Keywords: Adverse effects, Bacterial infection, Kidney transplantation, Rejection

Session Information

Date: Tuesday, June 14, 2016

Session Name: Poster Session D: Fungi, PJP, Mycobacteria, Infection Risk Factors, Vaccination and Donor Derived Infections

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Related Abstracts
  • Risk Factors for Clinical Urinary Tract Infections in Kidney Transplant Recipients with Asymptomatic Bacteriuria.
  • Prospective Comparative Study of a Strategy of Systematic Search and Treatment Versus No Treatment of Asymptomatic Bacteriuria (AB) in Kidney Transplant (KT) Recipients: Preliminary Results

Background. Renal transplant recipients (RTR) with asymptomatic bacteriuria (AB) are often treated with antibiotics. This could lead to complications related to antibiotic treatment including Clostridium difficile infection (CDI). Outcomes of untreated AB in RTR are unknown.

Methods. This was a retrospective analysis of RTR transplanted between April 2011 and March 2014. RTR with at least one AB episode in the first year post-transplant were included. Only the first AB episodes were analyzed. AB was defined as positive urine culture ≥104 cfu/mL in the absence of clinical symptoms. The primary outcome was occurrence of pyelonephritis, defined as bacteriuria with clinical symptoms and allograft tenderness. Subsequent symptomatic urinary tract infections (UTI), allograft rejection, and CDI were also analyzed. The Chi-square test was used with a p-value of <0.05 considered significant.

Results. A total of 214 RTR were identified; 36% (n=78) had at least one AB episode. Of these 78 AB episodes, 60% (n=47) were untreated. Common etiologies of AB episodes are shown in Table 1. The differences in 30-day rate of UTI (17% vs. 3%, p=0.13), 30-day pyelonephritis (2% vs. 0%, p=1), 1-year UTI (45% vs. 32%, p=0.39) and 1-year pyelonephritis (9% vs. 13% p=0.8)in the untreated vs. treated groups were not statistically significant. Rates of allograft rejection at 1-year (4% vs. 13%, p=0.33) and CDI at 1-year (4% vs 0%, p=ns) were also not different in the untreated vs. treated groups.

Conclusion. AB is common in RTR during the first year post-transplant. Although not statistically significant, 30-day UTI and pyelonephritis rates appear to be higher among patients who did not receive treatment for AB.

Organism

Untreated

Treated

Total

Coagulase-negative Staphylococcus spp.

Enterococcus spp.

Lactobacillus spp.

E. coli

Gardnerella vaginalis

Non-lactose fermenting Gram-negative rods

17

5

10

1

5

3

7

8

1

6

2

3

24

13

11

7

7

6

CITATION INFORMATION: Davis W, Lee R.-A, Daniels L, Todd S, True K, Chong P. Outcomes of Untreated Asymptomatic Bacteriuria in Renal Transplant Recipients: A Single-Center Experience. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Davis W, Lee R-A, Daniels L, Todd S, True K, Chong P. Outcomes of Untreated Asymptomatic Bacteriuria in Renal Transplant Recipients: A Single-Center Experience. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-of-untreated-asymptomatic-bacteriuria-in-renal-transplant-recipients-a-single-center-experience/. Accessed February 27, 2021.

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