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. 2024 Jan-Feb;34(1):37-44.
doi: 10.4103/ijn.ijn_407_22. Epub 2023 Jun 5.

Profile, Risk Factors, and Outcomes of Asymptomatic Bacteriuria in Kidney Transplant Recipients with Normal Pretransplant Genitourinary Tract: A Single-Center Experience

Selvin Sundar Raj Mani  1 , Athul Thomas  1 , Rizwan Alam  1 , Manish Lalwani  1 , Anna T Valson  1 , Bijesh Yadav  2 , Jeethu J Eapen  1 , Elenjickal E John  1 , Sabina Yusuf  1 , Rajiv P Mukha  3 , Muthu Krishna Pandian Rajadoss  3 , Deborah Mercy  1 , Suceena Alexander  1 , Santosh Varughese  1 , Vinoi G David  1
Affiliations

Profile, Risk Factors, and Outcomes of Asymptomatic Bacteriuria in Kidney Transplant Recipients with Normal Pretransplant Genitourinary Tract: A Single-Center Experience

Selvin Sundar Raj Mani et al. Indian J Nephrol. 2024 Jan-Feb.

Abstract

Introduction: There is a paucity of studies on asymptomatic bacteriuria (ASB) among kidney transplant recipients (KTR) in developing countries. This study assessed the clinical profile, risk factors, outcomes, and impact of treatment of ASB in KTRs with a normal genitourinary tract.

Methods: Consecutive KTRs from 2009 to 2018 with no clinical or radiological evidence of obstructive uropathy were included. Urinary tract infection (UTI) after ASB was defined as occurrence of cystitis, pyelonephritis, or urosepsis, with ASB being the first bacteriuric episode.

Results: Seven hundred ten out of 794 patients with median follow up of 47 months were included. The mean age was 35.5 ± 12 years. Eighty-one patients (11.4%) developed ASB at a median of 25 days (IQR 10, 134.5). Fifty-three percent and 4.9% of ASB episodes were extended-spectrum beta-lactamase (ESBL) positive and carbapenem-resistant organisms, respectively. Eighteen patients (32.1%) with early ASB (<3 months) and 5 (20%) with late ASB developed UTI on follow-up. Fifty-five percent of early and 16% of late ASB episodes were treated, with no significant difference observed in the risk of development of UTI when compared to untreated ASB episodes.

Conclusion: The incidence of ASB as first bacteriuric episode in our cohort was 11.4%, with there being significant antimicrobial resistance. Female gender, pretransplant UTI, and delayed graft function were independently associated with development of ASB. Treatment of ASB episodes either early or late did not decrease the risk of development of UTI.

Keywords: Asymptomatic bacteriuria; kidney transplant; normal pretransplant genitourinary tract; urinary tract infection.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Outcome of patients with early ASB on follow-up. All values are denoted as N (%). ASB = Asymptomatic bacteriuria, UTI = Urinary tract infection, C = Cystitis, P = Pyelonephritis, U = Urosepsis.
Figure 2:
Figure 2:
Outcome of patients with late ASB on follow-up. All values are denoted as N (%). ASB = Asymptomatic bacteriuria, UTI = Urinary tract infection, C = Cystitis, P = Pyelonephritis.
Figure 3:
Figure 3:
Time trend of treating ASB over the years. All values are denoted as N. ASB = Asymptomatic bacteriuria.
See this image and copyright information in PMC

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