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Updates on urinary tract infections in kidney transplantation

  • Marco Fiorentino
  • Francesco Pesce
  • Antonio Schena
  • Simona Simone
  • Giuseppe Castellano
  • Loreto GesualdoEmail author
Review

Abstract

Urinary tract infection (UTI) represents the most common infection after kidney transplantation; it is associated with an increased risk for acute kidney rejection and impaired graft function in the early post-transplant period. Kidney transplant recipients with UTIs are often clinically asymptomatic due to the immunosuppressive therapy; however, asymptomatic bacteriuria may progress to acute pyelonephritis, bacteremia and urosepsis, particularly in the early post-transplant period, that are independent risk factors for short and long-term graft and patient survival. This article reviews the definitions, incidence, risk factors and the management of UTI in kidney transplant recipients; furthermore, the main controversial and still unanswered questions, regarding the causes of recurrent UTIs, adequate use of antibiotics to avoid antibiotic resistance, dosing and timing for prophylaxis and treatment of symptomatic infections, are also discussed. The emerging definition of urinary microbiota introduces new concepts in understanding the complexity of the disease and might represent the future target for therapeutic interventions.

Keywords

Urinary tract infection Kidney transplantation Graft survival Urinary microbiota 

Notes

Acknowledgements

The results presented in this study have not been published elsewhere in whole or part. All authors approved the final version of the submitted manuscript.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors have declared no competing interests.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

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Copyright information

© Italian Society of Nephrology 2019

Authors and Affiliations

  1. 1.Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation‘Aldo Moro’ University of BariBariItaly

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