AUTHOR=Brune Jakob E. , Dickenmann Michael , Sidler Daniel , Walti Laura N. , Golshayan Déla , Manuel Oriol , Haidar Fadi , Neofytos Dionysios , Schnyder Aurelia , Boggian Katia , Mueller Thomas F. , Schachtner Thomas , Khanna Nina , Schaub Stefan , Wehmeier Caroline ,  the Swiss Transplant Cohort Study , Amico Patrizia , Aubert John-David , Bachofner Adrian , Banz Vanessa , Beckmann Sonja , Beldi Guido , Berger Christoph , Berishvili Ekaterine , Berzigotti Annalisa , Bochud Pierre-Yves , Branca Sanda , Bucher Heiner , Cairoli Anne , Catana Emmanuelle , Chalandon Yves , De Geest Sabina , De Seigneux Sophie , Dickenmann Michael , Lynn Dreifuss Joëlle , Duchosal Michel , Fehr Thomas , Ferrari-Lacraz Sylvie , Frossard Jaromil , Garzoni Christian , Golshayan Déla , Goossens Nicolas , Haidar Fadi , Halter Jörg , Heim Dominik , Hess Christoph , Hillinger Sven , Hirsch Hans , Hirt Patricia , Hoessly Linard , Hofbauer Günther , Huynh-Do Uyen , Immer Franz , Koller Michael , Kremer Andreas , Kuhn Christian , Laesser Bettina , Lamoth Frédéric , Lehmann Roger , Leichtle Alexander , Manuel Oriol , Marti Hans-Peter , Martinelli Michele , McLin Valérie , Mellac Katell , Merçay Aurélia , Mettler Karin , Müller Nicolas , Müller-Arndt Ulrike , Müllhaupt Beat , Nägeli Mirjam , Oldani Graziano , Pascual Manuel , Passweg Jakob , Pazeller Rosemarie , Posfay-Barbe Klara , Reineke David , Rick Juliane , Rosselet Anne , Rossi Simona , Rössler  , Rothlin Silvia , Ruschitzka Frank , Schachtner Thomas , Schaub Stefan , Scherrer Alexandra , Schneidawind Dominik , Schnyder Aurelia , Schuurmans Macé , Schwab Simon , Sengstag Thierry , Simonetta Federico , Steiger Jürg , Stirniman Guido , Stürzinger Ueli , Van Delden Christian , Venetz Jean-Pierre , Villard Jean , Vionnet Julien , Wick Madeleine , Wilhlem Markus , Yerly Patrick 

TITLE=Frequency and impact on renal transplant outcomes of urinary tract infections due to extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1329778

DOI=10.3389/fmed.2024.1329778

ISSN=2296-858X

ABSTRACT=Background: Enterobacterales are often responsible for urinary tract infection (UTI) in kidney transplant recipients. Among these, Escherichia coli or Klebsiella species producing extendedspectrum beta lactamase (ESBL) are emerging. However, there are only scarce data on frequency and impact of ESBL-UTI on transplant outcomes. Methods: We investigated frequency and impact of first-year UTI events with ESBL Escherichia coli and/or Klebsiella species in a prospective multicenter cohort consisting of 1482 kidney transplants performed between 2012 and 2017, focusing only on 389 kidney transplants having at least one UTI with Escherichia coli and/or Klebsiella species. The cohort had a median follow-up of four years. Results: In total, 139/825 (17%) first-year UTI events in 69/389 (18%) transplant recipients were caused by ESBL-producing strains. Both UTI phenotypes and proportion among all UTI events over time were not different compared with UTI caused by non-ESBL-producing strains. However, hospitalizations in UTI with ESBL-producing strains were more often observed (39% versus 26%, p=0.04). Transplant recipients with first-year UTI events with an ESBL-producing strain had more frequently recurrent UTI (33% versus 18%, p=0.02) but there was no significant difference in one-year kidney function as well as longer-term graft and patient survival between patients with and without ESBL-UTI. Conclusions: First-year UTI events with ESBL-producing Escherichia coli and/or Klebsiella species are associated with a higher need for hospitalization but do neither impact allograft function nor allograft and patient survival.