*Purpose: Risk factors for MDRO infections in kidney transplant recipients have previously been studied but limited to urinary tract infections. We sought to evaluate the rate and risk factors of all MDRO site infections.

*Methods: A retrospective chart review was performed on kidney transplant recipients from 2018 to 2019 at our transplant center. Recipients were followed for 1 year post transplantation to evaluate for infection. Demographic and clinical data were abstracted from the EMR. Analysis was completed using Fisher’s exact test, Student’s t-test, and descriptive statistics.

*Results: 300 transplant recipients were evaluated, 182/300(60.7%) were male and 118/300(39.3%) female. Mean age at transplant was 53 years. 163/300(54.3%) received a deceased donor kidney and 137/300(45.7%) received a living donor kidney. 64/300(21.3%) experienced delayed graft function, 51/300(17%) required hemodialysis post-transplant, and 13/300(4.3%) required treatment for rejection. The average duration of ureteral stents was 35.5 days. 128/300(42.7%) required readmission to the hospital. 72/300(24%) patients were treated for a total of 151 bacterial infections which included: complicated UTI/pyelonephritis 116/151(78.8%), blood stream 19/151(12.5%), intraabdominal 6/151(3.9%), gastrointestinal 5/151(3.3%), skin and soft tissue/surgical site 3/151(2.0%), and respiratory 2/151(1.3%). C. Difficile infection occurred in 5/300(1.7%). 5/300(1.7%) had laboratory confirmed MDRO infections. Of patients with documented infections, 5/72(6.9%) were MDRO, which included 3 gram-negatives (2 Enterobacteriaceae ESBLs, 1 MDR Pseudomonas Aeruginosa) and 2 gram-positives (1 VRE, 1 MRSA). No infections due to CRE Enterobacteriaceae were observed. Significant differences in patients with treated MDRO infections compared to those without are as follows; post-operative hemodialysis (60% vs 20.4%; p=0.04) and length of stay postoperatively (11.0 vs. 5.03 days; p=0.0003). There were no significant differences found between those with MDRO infections compared to those without for the following; average HbA1c(5.3 vs. 6.2; p=0.33), age(46.4 vs. 53.7; p=0.21), sex(male 1.6% vs. female 1.7%; p=1.0), delayed graft function(3.0% vs. 1.3%; p=0.29), mean duration of stents(27.6 vs. 35.6 days; p=0.1), and type donor (deceased 1.8% vs. living 1.5%; p=1.0).

*Conclusions: We observed a low prevalence of MDRO infections in our kidney transplant population. MDRO infections were associated with post-transplant hemodialysis and post-transplant length of stay.

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