Bacterial Infections in Renal Transplant Recipients.

BACKGROUND: Patients after kidney transplantation are highly susceptible to infections owing to immunosuppression as well as other risk factors--extended hospitalization, Foley catheterization, and double J catheter insertion among others. Bacterial infections, especially shortly after operation, are a major threat to the graft function. The aims of this study were to identify risk factors of bacterial infections after kidney transplantation and to determine the impact of those infections on the subsequent renal function. METHODS: One hundred twenty patients who underwent kidney transplantation in 2013 and 2014 were examined in our study for possible risk factors of bacterial infections and for possible outcome of such infections on their future condition. RESULTS: Among 120 patients under observation, 50 (41.7%) had early infectious complications (during hospitalization), 41 (82%) of which were urinary tract infections (UTI). The second most common infectious complication was infection of the surgical wound. Statistically significant results were obtained only for patient's age and duration of hospital stay (P = .001 and P = .000004, respectively). Bacterial infection resulted in longer hospital stay, higher reoperation risk, and lower creatinine clearance in the 14 days after transplantation (P = .000004, P = .0142, and P = .0455, respectively). CONCLUSION: Bacterial infections influence mainly the short-term condition of kidney transplant recipients: extended hospital stay, decreased early creatinine clearance, and enhanced risk of reoperation. The most common risk factors, such as Foley catheterization, double J catheter insertion, and diabetes, were not significant in our observation.

Is multiresistant Klebsiella pneumoniae New Delhi metallo-beta-lactamase (NDM-1) a new threat for kidney transplant recipients?

Urinary tract infections (UTIs) are the most frequent infections among kidney transplant (KT) patients. This case documents the emergence of New Delhi metallo-beta-lactamase (NDM-1) Klebsiella pneumonia--a factor of recurrent post-KT UTI, leading to graft loss. Spreading globally, and multidrug resistant, NDM-1 may become a great threat to transplant patients all over the world.