Posttransplant urinary tract infections and surgical site infections among renal transplant recipients in a transplant unit in Sri Lanka

Abstract

Aim: Kidney transplant (KT) recipients are at higher risks of infections due to the chronic disease conditions, the surgical procedure and immunosuppressive therapy following transplantation. We aimed to assess the incidence and the microbiology of urinary tract infections (UTIs) and surgical site infections (SSIs) in KT recipients at the transplant unit in Kandy Teaching Hospital, Sri Lanka. Methods: A prospective, descriptive study was carried out in patients undergoing KT for 6 months postoperatively. A urine full report and culture were carried out before transplantation and on days 1, 3, 7 and monthly for 6 months posttransplantation. Urine specimens yielding growth of ≥105 CFU/ml were considered significant. In addition, patients were screened preoperatively for Staphylococcus aureus colonization by multi-site swabbing. The surgical sites were inspected daily for SSI. Results: Thirty-nine patients were recruited in the study. Two patients (5.1%) had preoperative UTI and 4 (10.3%) developed UTI within 6 months. Majority of post-KT UTI (75.0%) occurred in the 1st month. UTI was commonly due to coliforms (50.0%) while S. aureus and Pseudomonas spp. accounted 25% each. All screened patients were colonized with S. aureus and majority (62.9%) were methicillin-resistant S. aureus. Only 3 (8.6%) KT recipients had SSIs. Conclusion: The incidence of UTI in KT recipients within the first 6 months was 10.3%, and majority occurred in the 1st month. Patients, who were treated for UTI preoperatively, did not develop post-KT UTI. Coliforms were the most common organism. Although there was high S. aureus colonization index, the incidence of SSI in post-KT recipients was low.

Keywords

• Kidney transplant
• Sri Lanka
• surgical site infections
• urinary tract infections