The Clinical Impact of Urinary Tract Infections on Graft Function among Kidney Transplant Recipients

Abstract

Urinary tract infection (UTI) is considered as one of the important bacterial infections seen among renal transplant
recipients (RTR). In this study, 117 RTRs (73 males and 44 females) were examined for the bacterial UTIs from
January to June 2014. UTIs were diagnosed in 33 patients [12 males (5 asymptomatic bacteriuria and 7 symptomatic
UTI) and 21 females (7 asymptomatic bacteriuria and 14 symptomatic UTI). 42 bacterial strains belonging to 16
different species were isolated from urine samples and identified by conventional tests and analytical profile index
(API) then confirmed by automated Phoenix system. The isolated bacteria were 76% (32/42) gram negatives and
24% (10/42) gram positives where gram negatives include K. pneumonia (43.8%), E. coli (18.8%), E. cloacae
(12.5%), K. oxytoca (6.3%), E. hermanni (3.1%), S. fonticola (3.1%), B. cepacia (3.1%), P. aerogenes (3.1%), Y.
pseudotuberculosis (3.1%), and E. aerogenes (3.1%) while gram positives include S. aureus (30%), S. saprophyticus
(20%), and S. porcinus (20%), S. kloosii (10%), S. agalactiae (10%), and E. faecalis (10%). Notably, infection with S.
aureus caused significant increase in serum creatinine and urea, whereas infection with K. pneumonia and S. fonticola
cause significant decrease in blood hemoglobin. Patients should be evaluated for UTIs during routine outpatient
follow-up, particularly female patients, considering the higher incidence of UTI in females