Institutional protocol adherence in the incidence of recurrent urinary tract infection after kidney transplantation

Imagem de Miniatura
Arquivos
art_FREIRE_Institutional_protocol_adherence_in_the_incidence_of_recurrent_2020.PDF (483.75 KB)
Citações na Scopus
5
Tipo de produção
article
Data de publicação
2020
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCI LTD
Autores
Citação
JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE, v.23, p.352-358, 2020
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objectives: Recurrent urinary tract infections (rUTIs) occur frequently after kidney transplantation (KT), however their optimal management remains undefined. This study aimed to identify risk factors for rUTI and to validate a protocol for UTI and rUTI treatment after KT. Methods: This retrospective cohort study involved patients undergoing KT between January 2013 and July 2016. Patients were followed-up from day of KT until graft loss, death or end of follow-up (31 December 2018). We analysed all episodes of symptomatic UTI. The main outcome measure was rUTI after KT. Analysis was done per episode in a multilevel approach; patient features were considered in the distal level and UTI features in the proximal level. Univariate and multivariate analyses were performed by Cox regression. A propensity score was used to adjust the risk of patients with carbapenem-resistant Enterobacteriaceae. Results: During the study period, 787 patients underwent KT, of whom 152 (19.3%) developed 356 UTI episodes. The most common micro-organisms wereEscherichia coli (165/356; 46.3%) and Klebsiella pneumoniae (101/356; 28.4%). Multidrug-resistant micro-organisms were isolated in 161 UTIs (45.2%). Risk factors for rUTI were diabetic nephropathy as the cause of end-stage renal disease (P = 0.02), UTI in first 180 days after KT (P = 0.04), anatomic alteration of the urinary tract at UTI diagnosis (P = 0.004) and length of time to effective therapy (P = 0.002); UTI treatment duration according to institutional protocol (P = 0.04) was the only protective factor identified. Conclusion: Appropriate therapy duration has an impact on rUTI prevention after KT. (C) 2020 The Authors.
Palavras-chave
Multidrug resistance, Stewardship, Treatment, Urinary tract infection, Kidney transplantation, Diabetic nephropathy
URI
https://observatorio.fm.usp.br/handle/OPI/39017
Referências
  1. Abbo LM, 2014, INFECT DIS CLIN N AM, V28, P263, DOI 10.1016/j.idc.2014.01.008
  2. Abbott KC, 2004, AM J KIDNEY DIS, V44, P353, DOI 10.1053/j.ajkd.2004.04.040
  3. Aguado JM, 2018, TRANSPLANT REV-ORLAN, V32, P36, DOI 10.1016/j.trre.2017.07.001
  4. Ariza-Heredia EJ, 2013, ANN TRANSPL, V18, P195, DOI 10.12659/AOT.883901
  5. Barber AE, 2013, CLIN INFECT DIS, V57, P719, DOI 10.1093/cid/cit284
  6. Bodro M, 2015, AM J TRANSPLANT, V15, P1021, DOI 10.1111/ajt.13075
  7. Bodro M, 2018, EXPERT REV ANTI-INFE, V16, P723, DOI 10.1080/14787210.2018.1509708
  8. Bodro M, 2013, TRANSPLANTATION, V96, P843, DOI 10.1097/TP.0b013e3182a049fd
  9. Britt NS, 2017, NEPHROL DIAL TRANSPL, V32, P1758, DOI 10.1093/ndt/gfx237
  10. Clinical and Laboratory Standards Institute, 2015, M100S25 CLSI S
  11. Espinar MJ, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0134737
  12. Fiorentino M, 2019, J NEPHROL, V32, P751, DOI 10.1007/s40620-019-00585-3
  13. Freire MP, 2015, INFECTION, V43, P315, DOI 10.1007/s15010-015-0743-4
  14. Freire MP, 2015, TRANSPLANTATION, V99, P521, DOI 10.1097/TP.0000000000000381
  15. Goldman JD, 2019, CLIN TRANSPLANT, V33, DOI 10.1111/ctr.13507
  16. Gupta K, 2011, CLIN INFECT DIS, V52, pE103, DOI 10.1093/cid/ciq257
  17. Korayem GB, 2018, J GLOB ANTIMICROB RE, V12, P119, DOI 10.1016/j.jgar.2017.08.009
  18. Lim JH, 2013, TRANSPL P, V45, P1584, DOI 10.1016/j.transproceed.2012.12.011
  19. Ljungman P, 2017, CLIN INFECT DIS, V64, P87, DOI 10.1093/cid/ciw668
  20. Loupy A, 2017, AM J TRANSPLANT, V17, P28, DOI 10.1111/ajt.14107
  21. Magiorakos AP, 2012, CLIN MICROBIOL INFEC, V18, P268, DOI 10.1111/j.1469-0691.2011.03570.x
  22. Mitra Subhashis, 2011, Curr Infect Dis Rep, V13, P579, DOI 10.1007/s11908-011-0210-z
  23. Munoz P, 2001, CLIN INFECT DIS, V33, pS53, DOI 10.1086/320905
  24. Parasuraman R, 2013, AM J TRANSPLANT, V13, P327, DOI 10.1111/ajt.12124
  25. Pinheiro HS, 2010, TRANSPL P, V42, P486, DOI 10.1016/j.transproceed.2010.02.002
  26. Pouch SM, 2019, CLIN TRANSPLANT, V33, DOI 10.1111/ctr.13594
  27. Satlin MJ, 2014, CLIN INFECT DIS, V58, P1274, DOI 10.1093/cid/ciu052
  28. Siedlecki A, 2011, AM J TRANSPLANT, V11, P2279, DOI 10.1111/j.1600-6143.2011.03754.x
  29. Singh R, 2015, CURR OPIN INFECT DIS, V28, P112, DOI 10.1097/QCO.0000000000000120
  30. Song JC, 2011, NEPHRON CLIN PRACT, V117, pC385, DOI 10.1159/000321526
  31. Tawab KA, 2017, EXP CLIN TRANSPLANT, V15, P157, DOI 10.6002/ect.2016.0069
  32. Vidal E, 2012, TRANSPL INFECT DIS, V14, P595, DOI 10.1111/j.1399-3062.2012.00744.x
  33. Vidal E, 2015, ENFERM INFEC MICR CL, V33, P679, DOI 10.1016/j.eimc.2015.03.024
  34. Wright KJ, 2007, CELL MICROBIOL, V9, P2230, DOI 10.1111/j.1462-5822.2007.00952.x
  35. Wu XH, 2016, AM J INFECT CONTROL, V44, P1261, DOI 10.1016/j.ajic.2016.04.222

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/47
Artigos e Materiais de Revistas Científicas - LIM/55
Artigos e Materiais de Revistas Científicas - ODS/03