Nosocomial infections in renal transplant patients: risk factors and treatment implications associated with urinary tract and surgical site infections

A prospective cohort study was conducted from January 2000 to December 2001 to determine the rate of bacterial nosocomial infections in renal transplant recipients. The patients were divided into two groups according to the origin of the allograft, namely deceased or living related donors. One hundr...

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Bibliographic Details
Published in:	The Journal of hospital infection Vol. 63; no. 2; pp. 117 - 123
Main Authors:	Dantas, S.R.P.E., Kuboyama, R.H., Mazzali, M., Moretti, M.L.
Format:	Journal Article
Language:	English
Published:	Kent Elsevier Ltd 01-06-2006 Elsevier
Subjects:	Adolescent Adult Aged Bacterial diseases Bacterial diseases of the urinary system Bacterial Infections - epidemiology Bacterial Infections - microbiology Bacterial Infections - prevention & control Biological and medical sciences Brazil - epidemiology Cross Infection - epidemiology Cross Infection - microbiology Cross Infection - prevention & control Enterobacter cloacae Female General aspects Human bacterial diseases Human infectious diseases. Experimental studies and models Humans Infectious diseases Kidney transplant Kidney Transplantation - adverse effects Logistic Models Male Medical sciences Middle Aged Molecular typing Multivariate Analysis Nephrology. Urinary tract diseases Nosocomial infection Prospective Studies Risk Factors Surgical Wound Infection - epidemiology Surgical Wound Infection - microbiology Surgical Wound Infection - prevention & control Urinary system involvement in other diseases. Miscellaneous Urinary Tract Infections - epidemiology Urinary Tract Infections - microbiology Urinary Tract Infections - prevention & control Urinary tract. Prostate gland Brazil Kidney transplant Nosocomial infection Molecular typing Human Surgical wound Urinary system disease Typing Urinary tract disease Kidney Urinary tract infection Microbiological investigation Treatment Risk factor Public health
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Summary:	A prospective cohort study was conducted from January 2000 to December 2001 to determine the rate of bacterial nosocomial infections in renal transplant recipients. The patients were divided into two groups according to the origin of the allograft, namely deceased or living related donors. One hundred and sixty-three renal transplant recipients were reviewed during hospitalization; 110 (67.5%) kidneys were from deceased donors and 53 (32.5%) kidneys were from living related donors. The median length of hospitalization was 12 days for transplants from living related donors and 26 days for transplants from deceased donors ( P < 0.0001). Twenty-one (39.6%) recipients of kidneys from living related donors and 68 (61.8%) recipients of kidneys from deceased donors had bacterial nosocomial infectious episodes ( P = 0.019). The post-transplant nosocomial infections diagnosed during hospitalization included urinary tract infections (UTIs) (44.8%), surgical site infections (SSIs) (11%), pneumonia (6.1%), catheter-related bloodstream infections (4.2%) and others (1.8%). Risk factors for UTI included: recipient of kidney from a deceased donor, substitution of the initial immunosuppressive regimen, duration of urinary bladder catheterization, and length of hospitalization before the infection. Six Enterobacter cloacae strains with multiple resistances to antibiotics were identified in UTIs, and hospital dissemination was documented using molecular typing. UTI was the single most important hospital infection and was significantly higher in recipients of kidneys from deceased donors ( P = 0.001).
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0195-6701 1532-2939
DOI:	10.1016/j.jhin.2005.10.018