Publication:
Impact of Treating Asymptomatic Bacteriuria in Kidney Transplant Recipients: A Prospective Cohort Study

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Abstract
This study aims to define the epidemiologic, clinical, and microbiological features of asymptomatic bacteriuria (AB) and cystitis in kidney transplantation recipients (KTRs), and to determine the impact of antimicrobial therapy of AB and the risk factors of cystitis. We conducted a prospective observational study of AB and cystitis in KTRs from January to June 2017. One-hundred ninety seven KTRs were included: 175 (88.8%) with AB and 22 (11.2%) with cystitis. The most frequent etiologies were Escherichia coli, Klebsiellapneumoniae, Enterococcusfaecalis, and Pseudomonas aeruginosa. No differences were observed regarding the etiologies, antimicrobial susceptibility patterns, and microbiologic outcomes in AB vs. cystitis. The treatment of AB diminished the microbiological cure and increased the rates of microbiologic relapses and reinfections; in addition, treated AB patients showed a trend of developing symptomatic urinary tract infection in the following six months. The analysis of the data identified the following independent risk factors for cystitis during the six months of follow-up: AB treatment, thymoglobulin induction, previous acute pyelonephritis, and time since transplantation < 1 year. In summary, considering the lack of clinical benefits of treating AB and its impact on cystitis development in the follow-up, we support the recommendation of not screening for or treating AB.
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MeSH Terms
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Urinary Tract Infections::Bacteriuria
Medical Subject Headings::Organisms::Bacteria::Gram-Positive Bacteria::Lactobacillales::Enterococcaceae::Enterococcus::Enterococcus faecalis
Medical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Klebsiella::Klebsiella pneumoniae
Medical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Pseudomonadaceae::Pseudomonas::Pseudomonas aeruginosa
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Renal Replacement Therapy::Kidney Transplantation
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Urinary Tract Infections
Medical Subject Headings::Diseases::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Nephritis::Nephritis, Interstitial::Pyelonephritis
Medical Subject Headings::Diseases::Male Urogenital Diseases::Urologic Diseases::Urinary Bladder Diseases::Cystitis
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents
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Keywords
Urinary tract infections, Kidney recipients, Asymptomatic bacteriuria, Cystitis, Prospective observational cohort, Infecciones urinarias, Receptores de trasplantes, Trasplante de riñón, Infecciones asintomáticas, Cistitis, Estudio observacional, Estudios de cohortes
Citation
Fontserè S, Infante-Domínguez C, Suárez-Benjumea A, Suñer-Poblet M, González-Corvillo C, Martín-Gutiérrez G, et al. Impact of Treating Asymptomatic Bacteriuria in Kidney Transplant Recipients: A Prospective Cohort Study. Antibiotics. 2021 Feb 22;10(2):218