Urinary tract infections in children following renal transplantation: a single-center experience

Urinary tract infection (UTI) is the most common complication after kidney transplantation and represents a potential life-threatening risk for the immunocompromised child. The aim of this report is to determinate incidence, risk factors, microbiologic features and evaluate the impact of this complication on graft outcome and patient mortality. We performed a retrospective cohort study reviewing the medical records of 17 children from 38 who received a renal transplant in our center between January 1992 and june 2008 and who present an urinary tract infection. All patients received Lich-Gregoire implantation and insertion of double-J stunt. Antibioprophylaxis was not systematic. After a mean period of 6 years, 9 children (5+4) developed early UTI (during the first month after transplantation) and 5 (3+2) had late UTI. Three patients (2+1) with an indeterminate nephropathy developed early and late UTI. Causal agents are: E. Coli, Klebsiella Pneumoniae and Candida albicans. The further voiding cystourethrography showed a vesico-ureteral reflux on graft in 5 cases. Among the 17 patients, 4 lost their graft and are actually on haemodialysis. The urinary tract infection represents the major complication after renal transplantation. Diagnosis ant treatment must be made early to avoid the loss of the graft.