Infectious complications during the first hospitalization after kidney transplantation and their relation to the short term outcomes

Aim of the study: To analyze and evaluate the frequency of infectious complications during the first hospitalization after kidney transplantation and the relationship of infections to the short term outcomes. Objectives: 1. Rate the frequency of infectious complications in transplanted patients during their hospitalization post – kidney transplantation in 2016 – 2017 2. Evaluate the most common infectious agents. 3. To evaluate the impact of infection on the duration of first hospitalization after kidney transplantation. 4. Evaluate the relationship of infections to graft function after 1 and 3 months. Material and methods: A retrospective study was conducted, the subjects were patients, who had a kidney transplantation performed in Lithuanian University of Health Sciences Hospital of Kaunas Clinics Nephrology Clinic in 2016 – 2017. Demographic data, data on emerging infections during post-transplantation hospitalization, duration of this hospitalization and impact of complications on graft function were collected. Results: 68 recipients were enrolled in this study, there were 65.7% males (44) and 35.3% females (24). Average hospital stay duration was 22.5 ± 13.7 days (8 – 97). Infectious complications occurred in 25% of the patients, out of all the patients there were 14.7% urinary tract infections (UTI), 10.3% pneumonia, 4.4% sepsis, 1.5% wound infection. In case of UTI agents have been identified: 3 cases of E. coli, 2 cases of Klebsiella pneumoniae, few cases of different other microorganisms were identified; in pneumonia 1 case of Cl. Pneumoniae; in sepsis – 2 cases of E.coli, 1 case of K. pneumoniae. Patients who had infectious complications were hospitalized for 30.5 ± 22.1 days, those who didn‘t – for 19.5 ± 6.8 days (p = 0.0015). Patients with urinary tract infections were hospitalized for 34.2 ± 26.3 days, with no UTI episodes – 20.3 ± 8.3 days (p = 0.13). Patients with sepsis were hospitalized for 48.3 ± 42.2 days, without sepsis – 21.2 ± 9.9 days (n=3, p=0.38). There was no significant relation between infectious complications and creatinine / GFR level 1 and 3 months after transplantation (p>0.05) Conclusions: One-quarter of post-transplantation patients experienced infectious complications in 2016 – 2017, urinary tract infections were the most common. After transplantation infectious complications’ agents are multi-faceted, the most commonly found were E. coli, K. pneumoniae. Infectious complications significantly prolonged the duration of hospitalization in the post-transplant period. Graft function was not affected by infectious complications