Introduction
In kidney transplant recipients, the risk of infection is increased
compared to the general population due to intensive immunosuppressive
drug use, surgical procedures and environmental factors. The most common
infections in renal transplant patients are urinary tract infections
(UTI). The UTI rate in renal transplant patients has been reported to
range between 20 to 80% [1-3].
Many different mechanisms and risk factors are responsible for the
increased frequency of UTI in renal transplant patients. The most
commonly reported risk factors are advanced age, female gender, diabetes
mellitus, urinary system abnormality and previous history of urinary
system infection. Deceased kidney transplantation, re-transplantation,
neurogenic bladder dysfunction, vesicoureteral reflux, and in-dwelling
urinary catheters also increase the risk of urinary tract infection. In
addition, intensive immunosuppressive use after transplantation also
contributes to the increased susceptibility to infections [2,4,5].
The microorganisms that cause these infections seem to differ between
countries and regions, but the most common causative microorganisms
uniformly throughout the world are gram-negative bacteria. These are, in
order of frequency, E. Coli (30-80%), Klebsiella (10%), Proteus (5%)
and Pseudomonas (5%). Gram-positive enterococci and Staphylococcus
aureus are also more common in these patients compared to the general
population [6-8]. Increasing prevalence of UTIs caused by
multidrug-resistant microorganisms is one of the major challenges in
transplant patients [6, 9, 10]. The latter situation makes UTI
management more complex with increased need for hospitalization at
higher costs.
The frequency of urinary tract infections may also differ between
countries and centers considering the environmental, social and economic
characteristics. Therefore, determining the frequency and risk factors
of urinary tract infections in each transplantation population is very
important for determining prevention and treatment strategies.
The aim of our study is to determine the incidence of urinary tract
infections among our kidney transplant recipients, to determine the
causative microorganisms as well as the underlying risk factors and to
determine the impact of UTI on short-term graft survival.