Urinary tract infection (UTI) is the most common bacterial infection following kidney transplantation (KT). The purpose of this study was to evaluate UTI following kidney transplantation. Medical records of all children who had been transplanted in Shiraz Nemazee Hospital and were under follow-up of pediatric nephrologists for 6 months to 15 years (mean=59.2±39 months) were reviewed and the data from their last visit was included in this study. Records of episodes of proved UTI following 1st month of transplantation were collected. SPSS 15.1 software was used for data analysis. Results Of two hundred and sixteen children ≤19 years at the time of transplantation, 138 patients were followed by pediatric nephrologists in Shiraz and included in this study. The mean age at transplantation time was 13.6±3.5 years with age range of 3 to 19 years. The male to female ratio was 1.33. Their Primary renal diseases were reflux-obstruction dysplasia (42%), hereditary-metabolic diseases (34%), glomerular diseases (19%), stone (1.5%) and unknown (3.5%). The kidney donors were deceased (47.8%), related (36.9%) with 80.3% parents, and unrelated (15.2%). The mode of dialysis before transplantation was hemodialysis in the majority of cases (85.5%) and 12.1% had preemptive transplantation. UTI occurred in 24(17.3%) of the children, 12 with only 1 episode, 3 with 2 episodes and more than 2 episodes in 8 patients. Regarding the relationship of UTI and primary renal diseases; 14 (24%) were in reflux-obstruction group, 6(12.5%) in hereditary disease, 3(11.5%) in glomerular disease, and 1 in stone disease group. Despite using prophylactic antibiotics by 9 patients (6.5%), recurrent UTI occurred in 5. Recurrent UTI occurred in 6 children with neurogenic bladder and in one child with stone disease despite post-transplant native nephrectomy in the latter. In conclusion, UTI is not common in children after first month of KT in our center, except with primary disease of reflux-obstruction and especially in those with neurogenic bladder.
Volume : 6
Issue : 4
Pages : 68
Shiraz Transplant Center, Namazi Hospital, Nephrology and Urology Research Center, Shiraz University of Medical Science, Shiraz, Iran.