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.