Impact of Treating Asymptomatic Bacteriuria in Kidney Transplant Recipients: A Prospective Cohort Study
This study aims to define the epidemiologic, clinical, and microbiological features of asymptomatic bacteriuria (AB) and cystitis in kidney transplantation recipients (KTRs), and to determine the impact of antimicrobial therapy of AB and the risk factors of cystitis. We conducted a prospective obser...
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| Veröffentlicht in: | Antibiotics (Basel) 2021-02, Vol.10 (2), p.218 |
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| creator | Fontserè, Sara Infante-Domínguez, Carmen Suárez-Benjumea, Alejandro Suñer-Poblet, Marta González-Corvillo, Carmen Martín-Gutiérrez, Guillermo Bernal, Gabriel Pachón, Jerónimo Pachón-Ibáñez, María Eugenia Cordero, Elisa |
| description | This study aims to define the epidemiologic, clinical, and microbiological features of asymptomatic bacteriuria (AB) and cystitis in kidney transplantation recipients (KTRs), and to determine the impact of antimicrobial therapy of AB and the risk factors of cystitis. We conducted a prospective observational study of AB and cystitis in KTRs from January to June 2017. One-hundred ninety seven KTRs were included: 175 (88.8%) with AB and 22 (11.2%) with cystitis. The most frequent etiologies were
,
,
, and
. No differences were observed regarding the etiologies, antimicrobial susceptibility patterns, and microbiologic outcomes in AB vs. cystitis. The treatment of AB diminished the microbiological cure and increased the rates of microbiologic relapses and reinfections; in addition, treated AB patients showed a trend of developing symptomatic urinary tract infection in the following six months. The analysis of the data identified the following independent risk factors for cystitis during the six months of follow-up: AB treatment, thymoglobulin induction, previous acute pyelonephritis, and time since transplantation < 1 year. In summary, considering the lack of clinical benefits of treating AB and its impact on cystitis development in the follow-up, we support the recommendation of not screening for or treating AB. |
| doi_str_mv | 10.3390/antibiotics10020218 |
| format | Article |
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,
,
, and
. No differences were observed regarding the etiologies, antimicrobial susceptibility patterns, and microbiologic outcomes in AB vs. cystitis. The treatment of AB diminished the microbiological cure and increased the rates of microbiologic relapses and reinfections; in addition, treated AB patients showed a trend of developing symptomatic urinary tract infection in the following six months. The analysis of the data identified the following independent risk factors for cystitis during the six months of follow-up: AB treatment, thymoglobulin induction, previous acute pyelonephritis, and time since transplantation < 1 year. In summary, considering the lack of clinical benefits of treating AB and its impact on cystitis development in the follow-up, we support the recommendation of not screening for or treating AB.</description><identifier>ISSN: 2079-6382</identifier><identifier>EISSN: 2079-6382</identifier><identifier>DOI: 10.3390/antibiotics10020218</identifier><identifier>PMID: 33671718</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Antibiotics ; Antiinfectives and antibacterials ; Asymptomatic ; asymptomatic bacteriuria ; Bacteriuria ; Cohort analysis ; Cystitis ; Disease prevention ; E coli ; Epidemiology ; Etiology ; kidney recipients ; Kidney transplantation ; Klebsiella ; Mortality ; Observational studies ; Pathogens ; prospective observational cohort ; Pseudomonas aeruginosa ; Pyelonephritis ; Risk analysis ; Risk factors ; Statistical analysis ; Surgical techniques ; Thymoglobulin ; Transplants & implants ; Urinary tract ; Urinary tract infections ; Urine ; Urogenital system</subject><ispartof>Antibiotics (Basel), 2021-02, Vol.10 (2), p.218</ispartof><rights>2021. This work is licensed under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c527t-35e3e32b77d1be615430788d7737bd9b25b4e9a7507ee9ad62fc725d366e279f3</citedby><cites>FETCH-LOGICAL-c527t-35e3e32b77d1be615430788d7737bd9b25b4e9a7507ee9ad62fc725d366e279f3</cites><orcidid>0000-0001-7969-8162 ; 0000-0002-8166-5308 ; 0000-0002-1750-8156</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926960/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926960/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33671718$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fontserè, Sara</creatorcontrib><creatorcontrib>Infante-Domínguez, Carmen</creatorcontrib><creatorcontrib>Suárez-Benjumea, Alejandro</creatorcontrib><creatorcontrib>Suñer-Poblet, Marta</creatorcontrib><creatorcontrib>González-Corvillo, Carmen</creatorcontrib><creatorcontrib>Martín-Gutiérrez, Guillermo</creatorcontrib><creatorcontrib>Bernal, Gabriel</creatorcontrib><creatorcontrib>Pachón, Jerónimo</creatorcontrib><creatorcontrib>Pachón-Ibáñez, María Eugenia</creatorcontrib><creatorcontrib>Cordero, Elisa</creatorcontrib><title>Impact of Treating Asymptomatic Bacteriuria in Kidney Transplant Recipients: A Prospective Cohort Study</title><title>Antibiotics (Basel)</title><addtitle>Antibiotics (Basel)</addtitle><description>This study aims to define the epidemiologic, clinical, and microbiological features of asymptomatic bacteriuria (AB) and cystitis in kidney transplantation recipients (KTRs), and to determine the impact of antimicrobial therapy of AB and the risk factors of cystitis. We conducted a prospective observational study of AB and cystitis in KTRs from January to June 2017. One-hundred ninety seven KTRs were included: 175 (88.8%) with AB and 22 (11.2%) with cystitis. The most frequent etiologies were
,
,
, and
. No differences were observed regarding the etiologies, antimicrobial susceptibility patterns, and microbiologic outcomes in AB vs. cystitis. The treatment of AB diminished the microbiological cure and increased the rates of microbiologic relapses and reinfections; in addition, treated AB patients showed a trend of developing symptomatic urinary tract infection in the following six months. The analysis of the data identified the following independent risk factors for cystitis during the six months of follow-up: AB treatment, thymoglobulin induction, previous acute pyelonephritis, and time since transplantation < 1 year. In summary, considering the lack of clinical benefits of treating AB and its impact on cystitis development in the follow-up, we support the recommendation of not screening for or treating AB.</description><subject>Antibiotics</subject><subject>Antiinfectives and antibacterials</subject><subject>Asymptomatic</subject><subject>asymptomatic bacteriuria</subject><subject>Bacteriuria</subject><subject>Cohort analysis</subject><subject>Cystitis</subject><subject>Disease prevention</subject><subject>E coli</subject><subject>Epidemiology</subject><subject>Etiology</subject><subject>kidney recipients</subject><subject>Kidney transplantation</subject><subject>Klebsiella</subject><subject>Mortality</subject><subject>Observational studies</subject><subject>Pathogens</subject><subject>prospective observational cohort</subject><subject>Pseudomonas aeruginosa</subject><subject>Pyelonephritis</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Surgical techniques</subject><subject>Thymoglobulin</subject><subject>Transplants & implants</subject><subject>Urinary tract</subject><subject>Urinary tract infections</subject><subject>Urine</subject><subject>Urogenital system</subject><issn>2079-6382</issn><issn>2079-6382</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNp9kltrFDEUxwdRbKn9BIIEfPFlay6TZOKDsF2sLhYUrc8hlzPbLDuTMckU9tuburW0IublJDn_8-PcmuYlwWeMKfzWjCXYEEtwmWBMMSXdk-aYYqkWgnX06YP7UXOa8xbXowjrcPe8OWJMSCJJd9xs1sNkXEGxR1cJTAnjBi3zfphKHOrLofPqhRTmFAwKI_oc_Aj7qjVjnnY1C_QNXJgCjCW_Q0v0NcU8gSvhBtAqXsdU0Pcy-_2L5llvdhlO7-xJ8-Piw9Xq0-Lyy8f1anm5cJzKsmAcGDBqpfTEgiC8ZVh2nZeSSeuVpdy2oIzkWEK1XtDeSco9EwKoVD07adYHro9mq6cUBpP2Opqgf3_EtNEm1bp2oLExpHPCKgDeQmsN5s4Qh7liFHPrK-v9gTXNdgDvao3J7B5BH3vGcK038UZLRYUSuALe3AFS_DlDLnoI2cGu9g3inDVtVdcqKjGv0td_SbdxTmNtlaacti0RdWL_VbWKScKJumWxg8rVYeQE_X3KBOvb7dH_2J4a9ephtfcxf3aF_QJ-3cOH</recordid><startdate>20210222</startdate><enddate>20210222</enddate><creator>Fontserè, Sara</creator><creator>Infante-Domínguez, Carmen</creator><creator>Suárez-Benjumea, Alejandro</creator><creator>Suñer-Poblet, Marta</creator><creator>González-Corvillo, Carmen</creator><creator>Martín-Gutiérrez, Guillermo</creator><creator>Bernal, Gabriel</creator><creator>Pachón, Jerónimo</creator><creator>Pachón-Ibáñez, María Eugenia</creator><creator>Cordero, Elisa</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T7</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M7P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-7969-8162</orcidid><orcidid>https://orcid.org/0000-0002-8166-5308</orcidid><orcidid>https://orcid.org/0000-0002-1750-8156</orcidid></search><sort><creationdate>20210222</creationdate><title>Impact of Treating Asymptomatic Bacteriuria in Kidney Transplant Recipients: A Prospective Cohort Study</title><author>Fontserè, Sara ; Infante-Domínguez, Carmen ; Suárez-Benjumea, Alejandro ; Suñer-Poblet, Marta ; González-Corvillo, Carmen ; Martín-Gutiérrez, Guillermo ; Bernal, Gabriel ; Pachón, Jerónimo ; Pachón-Ibáñez, María Eugenia ; Cordero, Elisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c527t-35e3e32b77d1be615430788d7737bd9b25b4e9a7507ee9ad62fc725d366e279f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antibiotics</topic><topic>Antiinfectives and antibacterials</topic><topic>Asymptomatic</topic><topic>asymptomatic bacteriuria</topic><topic>Bacteriuria</topic><topic>Cohort analysis</topic><topic>Cystitis</topic><topic>Disease prevention</topic><topic>E coli</topic><topic>Epidemiology</topic><topic>Etiology</topic><topic>kidney recipients</topic><topic>Kidney transplantation</topic><topic>Klebsiella</topic><topic>Mortality</topic><topic>Observational studies</topic><topic>Pathogens</topic><topic>prospective observational cohort</topic><topic>Pseudomonas aeruginosa</topic><topic>Pyelonephritis</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Statistical analysis</topic><topic>Surgical techniques</topic><topic>Thymoglobulin</topic><topic>Transplants & implants</topic><topic>Urinary tract</topic><topic>Urinary tract infections</topic><topic>Urine</topic><topic>Urogenital system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fontserè, Sara</creatorcontrib><creatorcontrib>Infante-Domínguez, Carmen</creatorcontrib><creatorcontrib>Suárez-Benjumea, Alejandro</creatorcontrib><creatorcontrib>Suñer-Poblet, Marta</creatorcontrib><creatorcontrib>González-Corvillo, Carmen</creatorcontrib><creatorcontrib>Martín-Gutiérrez, Guillermo</creatorcontrib><creatorcontrib>Bernal, Gabriel</creatorcontrib><creatorcontrib>Pachón, Jerónimo</creatorcontrib><creatorcontrib>Pachón-Ibáñez, María Eugenia</creatorcontrib><creatorcontrib>Cordero, Elisa</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Biological Science Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Antibiotics (Basel)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fontserè, Sara</au><au>Infante-Domínguez, Carmen</au><au>Suárez-Benjumea, Alejandro</au><au>Suñer-Poblet, Marta</au><au>González-Corvillo, Carmen</au><au>Martín-Gutiérrez, Guillermo</au><au>Bernal, Gabriel</au><au>Pachón, Jerónimo</au><au>Pachón-Ibáñez, María Eugenia</au><au>Cordero, Elisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Treating Asymptomatic Bacteriuria in Kidney Transplant Recipients: A Prospective Cohort Study</atitle><jtitle>Antibiotics (Basel)</jtitle><addtitle>Antibiotics (Basel)</addtitle><date>2021-02-22</date><risdate>2021</risdate><volume>10</volume><issue>2</issue><spage>218</spage><pages>218-</pages><issn>2079-6382</issn><eissn>2079-6382</eissn><abstract>This study aims to define the epidemiologic, clinical, and microbiological features of asymptomatic bacteriuria (AB) and cystitis in kidney transplantation recipients (KTRs), and to determine the impact of antimicrobial therapy of AB and the risk factors of cystitis. We conducted a prospective observational study of AB and cystitis in KTRs from January to June 2017. One-hundred ninety seven KTRs were included: 175 (88.8%) with AB and 22 (11.2%) with cystitis. The most frequent etiologies were
,
,
, and
. No differences were observed regarding the etiologies, antimicrobial susceptibility patterns, and microbiologic outcomes in AB vs. cystitis. The treatment of AB diminished the microbiological cure and increased the rates of microbiologic relapses and reinfections; in addition, treated AB patients showed a trend of developing symptomatic urinary tract infection in the following six months. The analysis of the data identified the following independent risk factors for cystitis during the six months of follow-up: AB treatment, thymoglobulin induction, previous acute pyelonephritis, and time since transplantation < 1 year. In summary, considering the lack of clinical benefits of treating AB and its impact on cystitis development in the follow-up, we support the recommendation of not screening for or treating AB.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>33671718</pmid><doi>10.3390/antibiotics10020218</doi><orcidid>https://orcid.org/0000-0001-7969-8162</orcidid><orcidid>https://orcid.org/0000-0002-8166-5308</orcidid><orcidid>https://orcid.org/0000-0002-1750-8156</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Antibiotics Antiinfectives and antibacterials Asymptomatic asymptomatic bacteriuria Bacteriuria Cohort analysis Cystitis Disease prevention E coli Epidemiology Etiology kidney recipients Kidney transplantation Klebsiella Mortality Observational studies Pathogens prospective observational cohort Pseudomonas aeruginosa Pyelonephritis Risk analysis Risk factors Statistical analysis Surgical techniques Thymoglobulin Transplants & implants Urinary tract Urinary tract infections Urine Urogenital system |
| title | Impact of Treating Asymptomatic Bacteriuria in Kidney Transplant Recipients: A Prospective Cohort Study |
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