Seenivasan, M (2013) Urinary Tract Infection in Renal Transplant Recipients - Clinical and Microbiological profile and risk factors and outcome. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Renal transplantation has a better quality of life and improved overall survival when compared to dialysis as a modality of management of end stage renal disease patients. When compared to patients staying on transplant waiting list, renal transplantation is associated with lower risk of mortality, in patients with diabetes, with different age group and in different ethnicity. Renal transplant outcome has improved over the past few decades, as a result of development of new immunosuppressive drugs. The introduction of drugs such as mycophenolate mofetil and Tacrolimus has decreased the incidence of acute rejection episodes. The reduction in acute rejection episodes has improved the short-term renal survival. In spite of advances in prophylaxis and treatment, infection remains the major cause of morbidity and mortality in patients with renal transplant. Urinary tract infection (UTI) is a common bacterial infection in renal transplant recipient10. The majority of infections occur in the first year following transplantation. UTI can worsen the graft and patient survival, may be associated with increased morbidity and mortality risk in renal transplant recipient. A significant percent of patients may develop acute pyelonephritis, which is a risk factor for graft deterioration. AIM : 1. To study the clinical and microbiological profile of urinary tract infection in renal transplant recipients. 2. To study the risk factors for urinary tract infection in renal transplant recipients. 3. To study the effect of urinary tract infection on graft function and long term graft survival. MATERIALS AND METHODS : Patients attending renal transplant clinic and those admitted in renal transplant ward, Department of Nephrology, Madras Medical College, from July 2011 to December 2012, with fever or urinary symptoms in the form of dysuria, frequency, urgency suprapubic pain or pain over graft, or fever of unknown origin. CONCLUSIONS : 1. Urinary tract infection is a common infection in renal transplant recipients. 2. Klebsiella species is the commonest organism causing urinary tract infection in this study. 3. There is no correlation with cytomegalovirus disease, pre existing diabetes, NODAT (New Onset Diabetes After Transplantation) and anti rejection therapy on the occurrence of urinary tract infection. 4. The incidence of urinary tract infection is increased in those with hepatitis C virus coinfection. 5. Urinary infection is increased as a function of number of days of indwelling urethral catheterization post transplant, with more incidence of urinary tract infection with increased number of catheter days. 6. The incidence of urinary tract infection is not increased in those with prophylactic stenting. 7. Urinary tract infection in the renal transplant recipients is associated with poor long term graft function.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Urinary Tract Infection ; Renal Transplant Recipients ; Clinical and Microbiological profile ; risk factors and outcome. |
| Subjects: | MEDICAL > Nephrology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 11 Jul 2017 05:12 |
| Last Modified: | 11 Jul 2017 05:12 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1376 |
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