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URINARY TRACT INFECTIONS AFTER RENAL TRANSPLANTATION: IS MALE GENDER A RISK FACTOR FOR RESISTANT AND RECURRENT INFECTIONS?
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  • Gokhan Guneri,
  • Arzu Velioglu,
  • Hakki Arikan ,
  • Ebru Asicioglu,
  • Yiloren Tanidir,
  • Ilker Tinay,
  • Cumhur Yegen,
  • Serhan Tuglular
Gokhan Guneri
Marmara University School of Medicine
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Arzu Velioglu
Marmara University School of Medicine
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Hakki Arikan
Marmara University School of Medicine
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Ebru Asicioglu
Marmara University School of Medicine
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Yiloren Tanidir
Marmara University School of Medicine
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Ilker Tinay
Marmara University School of Medicine
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Cumhur Yegen
Marmara University School of Medicine
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Serhan Tuglular
Marmara University School of Medicine
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Abstract

Background: The most common infections among renal transplant patients are urinary tract infections (UTI). Our main objective in this study is to determine the incidence of UTIs in patients who have undergone renal transplantation in our hospital, to identify the causative microbiological agents, risk factors and determine the effects of UTI on short-term graft survival. Methods: Adult patients, who underwent renal transplantation between October 2011 and July 2018, were included in this study. Urinary tract infections which developed within the first year of renal transplantation were investigated. Patients were compared regarding demographic, clinical, laboratory characteristics, and graft survival. Results: 102 patients were included in our study. Forty patients (51.9%) were male and 37 (48.1%) were female. Sixty-seven urinary tract infection attacks in 21 patients were recorded. Age (p=0.009; 95% Confidence Interval [CI]: 1.014-1.105), longer indwelling urinary catheter stay time (p=0.027; 95% Confidence Interval [CI]: 1.010-1.174) and urologic complications (p=0.032; 95% Confidence Interval [CI]: 0.094-0.896) were found as risk factors for UTI development in the first year of transplantation. Escherichia coli and Klebsiella pneumoniae were the most frequently isolated microorganisms. Of these bacteria, 63.2 % were found to be extended spectrum beta lactamase (ESBL) positive. Resistant microorganisms were more frequent in male patients (31 episodes in males vs. 12 episodes in females, p=0.0015). UTI had no negative impact on short-term graft survival. Conclusion: Patients with advanced age, who had a longer duration of bladder catheterization and urologic complications should be followed carefully regarding UTI. Since there is a high incidence of UTI in male transplant patients, more frequently caused by resistant microorganisms, infection control methods should be applied more vigorously especially in male transplant patients.