Infectious complications and antibiotic use in renal transplant recipientsduring a 1-year follow-up

Objective To evaluate infectious complications and antibiotic use in 192 re nal transplant recipients. Methods Infectious complications and antibiotic use were monitored in all p atients receiving renal transplantation at our center from 1992 to 1997. Ri sk factors for infectious complications were evaluated. Transplants and pat ient survival were monitored. The follow-up period was 1 year. Results One-hundred and ninety-two patients received renal transplants duri ng the study period. The mean duration of urethral catheterisation after tr ansplantation was 10.5 days (SD=5). Seventy-one per cent (n=137) of patient s had at least one infectious episode. In all, 284 infectious episodes were monitored. The most frequent infections were: urinary tract infections 61% , respiratory tract infections 8%, intra-abdominal infections 7%, and cytom egalovirus infection 8%. Escherichia coli and Enterococcus faecalis were th e most frequently isolated microorganisms. Seventy-four per cent (n=142) of patients received 314 antimicrobial courses (284 for therapy, and 30 for p rophylaxis). Female gender and duration of urethral catheterisation were ri sk factors for urinary tract infection. Cytomegalovirus reactivation was as sociated with acute graft rejection and additional immunosuppressive therap y. Overall mortality was 4%. Infection-related mortality was 2.6%. Mortalit y was associated with Enterobacteriaceae in three patients, with Pseudomona s aeroginosa in one patient and with Enterococcus faecalis in one patient. Conclusions The incidence of infectious complications remains high in renal transplant recipients. Most cases of mortality were associated with infect ions. Early removal of the urethral catheter to reduce the risk of urinary tract infections is recommended.