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. 2022 Jul;22(7):1823-1833.
doi: 10.1111/ajt.17026. Epub 2022 Mar 26.

Impact of different urinary tract infection phenotypes within the first year post-transplant on renal allograft outcomes

Jakob E Brune  1 , Michael Dickenmann  1 , Caroline Wehmeier  1 , Daniel Sidler  2 , Laura Walti  3 , Dela Golshayan  4 , Oriol Manuel  5 , Karine Hadaya  6 , Dionysios Neofytos  7 , Aurelia Schnyder  8 , Katia Boggian  9 , Thomas Müller  10 , Thomas Schachtner  10 , Nina Khanna  11 , Stefan Schaub  1   12 ; Swiss Transplant Cohort Study
Affiliations

Impact of different urinary tract infection phenotypes within the first year post-transplant on renal allograft outcomes

Jakob E Brune et al. Am J Transplant. 2022 Jul.

Abstract

In this study, we investigated the clinical impact of different urinary tract infection (UTI) phenotypes occurring within the first year after renal transplantation. The population included 2368 transplantations having 2363 UTI events. Patients were categorized into four groups based on their compiled UTI events observed within the first year after transplantation: (i) no colonization or UTI (n = 1404; 59%), (ii) colonization only (n = 353; 15%), (iii) occasional UTI with 1-2 episodes (n = 456; 19%), and (iv) recurrent UTI with ≥3 episodes (n = 155; 7%). One-year mortality and graft loss rate were not different among the four groups, but patients with recurrent UTI had a 7-10 ml/min lower eGFR at year one (44 ml/min vs. 54, 53, and 51 ml/min; p < .001). UTI phenotypes had no impact on long-term patient survival (p = .33). However, patients with recurrent UTI demonstrated a 10% lower long-term death-censored allograft survival (p < .001). Furthermore, recurrent UTI was a strong and independent risk factor for reduced death-censored allograft survival in a multivariable analysis (HR 4.41, 95% CI 2.53-7.68, p < .001). We conclude that colonization and occasional UTI have no impact on pertinent outcomes, but recurrent UTI are associated with lower one-year eGFR and lower long-term death-censored allograft survival. Better strategies to prevent and treat recurrent UTI are needed.

Keywords: allograft loss; patient survival; renal transplantation; urinary tract infection.

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Figures

FIGURE 1
FIGURE 1
Overview of the frequency/incidence and temporal distribution of infection phenotypes observed within the first year post‐transplant [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
Overview and temporal distribution of detected bacteria/fungi according to infection phenotype [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
Long‐term patient and death‐censored allograft survival among 2245 patients having a functioning allograft at 1 year post‐transplant, grouped by UTI phenotypes observed within the first year post‐transplant. [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 4
FIGURE 4
Distribution of pathogens observed in the “1–2 UTI” and “≥3 UTI” groups, stratified by the infection phenotype. [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

References

    1. van Delden C, Stampf S, Hirsch HH, et al. Burden and timeline of infectious diseases in the first year after solid organ transplantation in the Swiss Transplant Cohort Study. Clin Infect Dis. 2020;71(7):e159‐e169. - PMC - PubMed
    1. Jackson KR, Motter JD, Bae S, et al. Characterizing the landscape and impact of infections following kidney transplantation. Am J Transplant. 2021;21(1):198‐207. - PubMed
    1. Müller V, Becker G, Delfs M, Albrecht KH, Philipp T, Heemann U. Do urinary tract infections trigger chronic kidney transplant rejection in man? J Urol. 1998;159(6):1826‐1829. - PubMed
    1. Karakayali H, Emiroğlu R, Arslan G, Bilgin N, Haberal M. Major infectious complications after kidney transplantation. Transplant Proc. 2001;33(1–2):1816‐1817. - PubMed
    1. Naik AS, Dharnidharka VR, Schnitzler MA, et al. Clinical and economic consequences of first‐year urinary tract infections, sepsis, and pneumonia in contemporary kidney transplantation practice. Transpl Int. 2016;29(2):241‐252. - PMC - PubMed

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