A Five-Year Retrospective Study Focused on Urinary Tract Infections in Kidney Transplant Recipients in the Current Era of immunosuppression.

Jorge Andrade Sierra^1,2*Jorge Carlos Andrade-Martínez²Elsa Angélica Fuentes-López²Enrique Rojas-Campos²Victor Martínez-Mejía²Eduardo González-Espinoza²Ernesto German Cardona-Muñoz¹José Ignacio Cerrillos-Gutiérrez²Luis Alberto Evangelista-Carrillo²Miguel Medina-Pérez²Moises Landino Cruz²Adriana Banda-Lopez²Alejandra Guillermina Miranda-Díaz¹J. Ahuixotl Gutiérrez Aceves²Jorge Andrade-Ortega¹Kevin Javier Arellano Arteaga³Antonio de Jesús Andrade-Ortega¹Laura Elizabeth Aguilar-Fletes²Gerardo González-Correa²Priscila Preciado²Joel E Verdugo-Correa²Héctor Leonardo Pazarín-Villaseñor²Ana Luisa Corona-Nakamura²Mauricio Carvallo-Venegas²

• ¹University of Guadalajara, Guadalajara, Mexico
• ²Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Mexico
• ³Civil Hospital of Guadalajara, Guadalajara, Mexico

After kidney transplantation, UTI are the most common infection concern and can cause acute renal injury (AKI) in allografts. However, long-term allograft function, loss, and mortality risk are inconsistent. A retrospective cohort research of 1,341 kidney transplant recipients (KTR) from January 2014 to March 2019 assessed UTI incidence, risk factors, and consequences on AKI and allograft function in the first year.All first-year post-transplant UTI patients were recorded. Third-generation cephalosporin (1 gr, two doses) and 500 mg intravesical amikacin were given to all patients one day before surgery. After that, patients had TMP-SMX (160/800mg qd) for 3-4 months to prevent Pneumocystis jirovecii pneumonia, and the main immunosuppressive regimen was mycophenolate mofetil, prednisone and a Calcineurin inhibitors.The UTI incidence was 42.5%. Escherichia coli was the most common causal bacteria, accounting for a significant amount of strains of Extended-spectrum betalactamase (ESBL) and AKI occurred more in the first and second UTI. Our analysis showed risk factors of anti-thymocyte globulin (ATG) use (RR 1.52; p=0.032), double J catheter (RR 1.9; p=0.004), and urinary tract abnormalities (RR 1.92; p= 0.007).Although UTI was common and associated with AKI, it did not affect allograft function at 12 months post-transplantation.