PMID- 28967964
OWN - NLM
STAT- MEDLINE
DCOM- 20180319
LR  - 20180319
IS  - 1460-2385 (Electronic)
IS  - 0931-0509 (Linking)
VI  - 32
IP  - 10
DP  - 2017 Oct 1
TI  - Effects of recurrent urinary tract infections on graft and patient outcomes after
      kidney transplantation.
PG  - 1758-1766
LID - 10.1093/ndt/gfx237 [doi]
AB  - Background: Urinary tract infections (UTIs) are common following kidney
      transplantation (KT); however, the influence of recurrent post-KT UTI (R-UTI) is 
      not well-characterized. Methods: We compared graft outcomes, patient outcomes and
      multidrug-resistance rates between patients with no UTI, nonrecurrent UTI
      (NR-UTI) (urine sample containing >105 bacterial colony-forming units/mL) and
      R-UTI (>/=2 UTIs in any 6-month period or >/=3 UTIs in any 12-month period)
      post-KT in a retrospective cohort study (1999-2014) at Barnes-Jewish Hospital (St
      Louis, MO). All adult KT recipients were included and those experiencing
      mortality within 30 days of KT were excluded. Results: Of 2469 recipients
      included, 1835 (74.3%) had no UTI, 465 (18.8%) had NR-UTI and 169 (6.8%) had
      R-UTI. R-UTI was associated with poorer graft survival compared with NR-UTI
      [hazard ratio (HR) 1.45; 95% confidence interval (CI) 1.23-1.83; P < 0.001) and
      no UTI (HR 2.11; 95% CI 2.02-3.80; P < 0.001). This relationship persisted after 
      adjusting for confounding factors in Cox regression (HR 2.01; 95% CI 1.53-2.66; P
      < 0.001). There was no difference in patient survival between no UTI and NR-UTI
      (HR 1.21; 95% CI 0.91-1.63; P = 0.181); however, R-UTI was associated with poorer
      patient survival compared with nonrecurrent cases (HR 1.87; 95% CI 1.21-2.89; P =
      0.005). R-UTI were more likely to be caused by multidrug-resistant Gram-negative 
      organisms (risk ratio 1.49; 95% CI 1.31-1.70; P < 0.001). Conclusions: R-UTIs
      were associated with poorer graft and patient outcomes, as well as increased
      multidrug-resistance compared with nonrecurrent cases.
CI  - (c) The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. 
      All rights reserved.
FAU - Britt, Nicholas S
AU  - Britt NS
AD  - Department of Pharmacy, Barnes-Jewish Hospital, St Louis, MO, USA.
FAU - Hagopian, Jennifer C
AU  - Hagopian JC
AD  - Department of Pharmacy, Barnes-Jewish Hospital, St Louis, MO, USA.
AD  - Department of Medicine, Division of Nephrology, Washington University School of
      Medicine, St Louis, MO, USA.
FAU - Brennan, Daniel C
AU  - Brennan DC
AD  - Department of Medicine, Division of Nephrology, Washington University School of
      Medicine, St Louis, MO, USA.
FAU - Pottebaum, April A
AU  - Pottebaum AA
AD  - Department of Pharmacy, Barnes-Jewish Hospital, St Louis, MO, USA.
FAU - Santos, Carlos A Q
AU  - Santos CAQ
AD  - Department of Internal Medicine, Division of Infectious Diseases, Rush University
      Medical Center, Chicago, IL, USA.
FAU - Gharabagi, Ara
AU  - Gharabagi A
AD  - Department of Medicine, Division of Nephrology, Washington University School of
      Medicine, St Louis, MO, USA.
FAU - Horwedel, Timothy A
AU  - Horwedel TA
AD  - Department of Pharmacy, Barnes-Jewish Hospital, St Louis, MO, USA.
AD  - Department of Medicine, Division of Nephrology, Washington University School of
      Medicine, St Louis, MO, USA.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
SB  - IM
MH  - Female
MH  - Graft Rejection/*diagnosis/etiology
MH  - *Graft Survival
MH  - Humans
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Urinary Tract Infections/*etiology
OTO - NOTNLM
OT  - kidney transplant infection
OT  - kidney transplantation
OT  - multidrug-resistance
OT  - transplant infectious diseases
OT  - urinary tract infection
EDAT- 2017/10/03 06:00
MHDA- 2018/03/20 06:00
CRDT- 2017/10/03 06:00
PHST- 2017/04/13 00:00 [received]
PHST- 2017/06/13 00:00 [accepted]
PHST- 2017/10/03 06:00 [entrez]
PHST- 2017/10/03 06:00 [pubmed]
PHST- 2018/03/20 06:00 [medline]
AID - 4079962 [pii]
AID - 10.1093/ndt/gfx237 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2017 Oct 1;32(10):1758-1766. doi: 10.1093/ndt/gfx237.