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ORIGINAL ARTICLE
Year : 2018  |  Volume : 12  |  Issue : 4  |  Page : 243-246

Noisy orchestra - Renal transplant and urinary tract infections


1 Department of Medicine and infectious Diseases, Sher-i-kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
2 Department of Nephrology, Sher-i-kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
3 Department of Urology, Sher-i-kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
4 Department of Microbiology, Sher-i-kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

Correspondence Address:
Dr. Ajaz Nabi Koul
Department of Medicine and Infectious Diseases, SKIMS, Srinagar, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijot.ijot_28_18

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Introduction: Kidneys are the most frequently transplanted organs; renal transplantation is the preferred method for treating patients with chronic kidney disease; and posttransplantation urinary tract infection (UTI) is still a source of morbidity and graft failure. Materials and Methods: This prospective study was conducted during the period of August 2016 to February 2018. A total of 35 renal transplant recipients were included in the study. Results: The most common symptom associated with the infection was dysuria (71%). Only 66% of the cases were febrile. Almost 17% of the cases presented with shock. Urine culture was positive in 23 (65%) cases, with bacteria in 22 (96%) and fungus in 1 (4%). Predominant bacteria grown from cultures were Klebsiella pneumoniae 32%, Pseudomonas aeruginosa 18%, Escherichia coli 14%, Enterococcus faecalis 13%, Acinetobacter 10%, Staphylococcus aureus 9%, and Enterobacter 4%. Antibiotic resistance profiles showed a high resistance patterns to ceftriaxone 60%, levofloxacin 53%, nitrofurantoin 53%, ciprofloxacin 40%, cotrimoxazole 40%, piperacillin–tazobactam 26%, amikacin 26%, gentamicin 26%, meropenem 26%, and imipenem 13%. Patients were followed up over a period of 4 weeks. At the 2nd week of follow-up, 2 (5%) cases were still culture positive, and the symptoms of UTI persisted in 6 (17%) cases. Of 35 cases, 25 were followed up till the 4th week. Culture positive was noted in 6 (24%) cases, and the symptoms persisted in 10 (40%) cases. In recurrent infections, relapses were noted in 3 (50%) cases and reinfections in 3 (50%). Conclusion: In these high-risk patients, antibiotic selection, duration, and stewardship need to be readdressed. Microbial profile and sensitivity patterns in such patients are different from the usual UTIs.


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