Urinary tract infection in kidney transplantation and its association with the use of ureteral stents

Abstract

Introduction: The use of double-J ureteral stent in renal transplantation has been associated to the reduction in the urologic complications, but its impact on the frequency of UTI is variable. Purpose: This study was designed to determine the frequency of UTI after renal Tx, the pathogen involved, frequency of use of double-J ureteral stent in the studied population and to assess the impact of the use of double-J stent on the frequency of UTI in kidney transplanted recipients. Methods: We included in this retrospective cohort study all kidney transplant performed at Walter Cantídeo University Hospital between January 1998 and August 2004 with at least 3 months of post-transplant follow-up. Data collection was performed by reviewing medical records and ambulatory charts from the transplant up to the end of follow-up period. We assessed the frequency of UTI, the post-transplant time of UTI diagnosis, the main pathogens involved, used therapy, frequency of use of double-J urethral stent and occurrence of urinary fistulae in the studied population. Results: The frequency of UTI was 47%. The main pathogens identified were Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa. A double-J ureteral stent was used in 69% of patients with average stay of 20 days. The use of double-J ureteral stent in the Tx surgery had no impact on the frequency of urinary fistula, but it was associated to a 2,98 times higher chance to develop UTI compared to the group which did not use double J. Conclusions: The UTI incidence in the studied population was 47%. A double-J ureteral stent was used in 69% of patients with no impact on the frequency of urinary fistula, but was associated to a 2,98 times higher chance to develop UTI.