Britt NS, et al. - This study focused on the impacts of recurrent post-kidney transplantation (KT) urinary tract infection (UTI) [(R-UTI)]. Findings demonstrated that poorer graft and patient outcomes, as well as increased multidrug-resistance, were observed in association with R-UTIs versus nonrecurrence of UTI post-KT.

Methods

• In a retrospective cohort study (1999–2014) at Barnes-Jewish Hospital (St Louis, MO), researchers 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.
• All adult KT recipients were included and those experiencing mortality within 30 days of KT were excluded.

Results

• Data revealed that out of 2469 recipients included, 1835 (74.3%) had no UTI, 465 (18.8%) had NR-UTI and 169 (6.8%) had R-UTI.
• Findings demonstrated that 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).
• Researchers observed that this link persisted after adjusting for confounding factors in Cox regression (HR 2.01; 95% CI 1.53–2.66; P < 0.001).
• They also noted that 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).
• In addition, it was seen that 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).