Risk factors for single and recurrent symptomatic urinary tract infections within the first year after kidney transplantation

Urinary Tract Infection (UTI) is the most common infection after kidney transplantation (KT). However studies have been incongruent regarding risk factors associated with incidence and recurrence of symptomatic UTIs in this population. We identified patients who underwent KT between 01/2012 to 12/2013 and developed symptomatic single or recurrent UTI within the first year of transplant. Recurrent infection was defined as having at least 2 UTIs in 6 months or 3 UTIs in one year. Demographic information, medical comorbidities and transplant variables were assessed for association with single and recurrent UTIs. 190 patients underwent KT during the study period. After excluding asymptomatic bacteriuria, a total of 36 patients developed a UTI within the first year of which 18 had recurrent UTIs. Factors associated with developing UTI (single or recurrent) were female gender∗ and repeat KT∗. Patients with recurrent UTIs (vs. single) were significantly more likely to be diabetics∗ , to have higher comorbidity index∗. KT recipients with recurrent UTI had significantly higher incidence of adverse renal outcomes, defined as increase in serum creatinine by 50% during the first year of transplant∗. Interestingly there was a significant association between isolation of Klebsiella pneumoniae in the index urine culture and the likelihood of recurrent UTI ∗. UTI is a frequent problem after KT and has high likelihood of recurrence. Multiple demographic, transplant and microbiological factors interplay as significant predisposing factors. (Table Presented)