PDF(Pubmed)
Abstract：
UNASSIGNED: There is a paucity of studies on asymptomatic bacteriuria (ASB) among kidney transplant recipients (KTR) in developing countries. This study assessed the clinical profile, risk factors, outcomes, and impact of treatment of ASB in KTRs with a normal genitourinary tract.
UNASSIGNED: Consecutive KTRs from 2009 to 2018 with no clinical or radiological evidence of obstructive uropathy were included. Urinary tract infection (UTI) after ASB was defined as occurrence of cystitis, pyelonephritis, or urosepsis, with ASB being the first bacteriuric episode.
UNASSIGNED: Seven hundred ten out of 794 patients with median follow up of 47 months were included. The mean age was 35.5 ± 12 years. Eighty-one patients (11.4%) developed ASB at a median of 25 days (IQR 10, 134.5). Fifty-three percent and 4.9% of ASB episodes were extended-spectrum beta-lactamase (ESBL) positive and carbapenem-resistant organisms, respectively. Eighteen patients (32.1%) with early ASB (<3 months) and 5 (20%) with late ASB developed UTI on follow-up. Fifty-five percent of early and 16% of late ASB episodes were treated, with no significant difference observed in the risk of development of UTI when compared to untreated ASB episodes.
UNASSIGNED: The incidence of ASB as first bacteriuric episode in our cohort was 11.4%, with there being significant antimicrobial resistance. Female gender, pretransplant UTI, and delayed graft function were independently associated with development of ASB. Treatment of ASB episodes either early or late did not decrease the risk of development of UTI.
UNASSIGNED: Consecutive KTRs from 2009 to 2018 with no clinical or radiological evidence of obstructive uropathy were included. Urinary tract infection (UTI) after ASB was defined as occurrence of cystitis, pyelonephritis, or urosepsis, with ASB being the first bacteriuric episode.
UNASSIGNED: Seven hundred ten out of 794 patients with median follow up of 47 months were included. The mean age was 35.5 ± 12 years. Eighty-one patients (11.4%) developed ASB at a median of 25 days (IQR 10, 134.5). Fifty-three percent and 4.9% of ASB episodes were extended-spectrum beta-lactamase (ESBL) positive and carbapenem-resistant organisms, respectively. Eighteen patients (32.1%) with early ASB (<3 months) and 5 (20%) with late ASB developed UTI on follow-up. Fifty-five percent of early and 16% of late ASB episodes were treated, with no significant difference observed in the risk of development of UTI when compared to untreated ASB episodes.
UNASSIGNED: The incidence of ASB as first bacteriuric episode in our cohort was 11.4%, with there being significant antimicrobial resistance. Female gender, pretransplant UTI, and delayed graft function were independently associated with development of ASB. Treatment of ASB episodes either early or late did not decrease the risk of development of UTI.
摘要：
■在发展中国家的肾移植受者（KTR）中，关于无症状菌尿（ASB）的研究很少。这项研究评估了临床概况，危险因素，结果，ASB治疗对泌尿生殖道正常的KTRs的影响。
■包括2009年至2018年连续的KTR，没有阻塞性尿路病的临床或放射学证据。ASB后尿路感染（UTI）定义为膀胱炎的发生，肾盂肾炎,或者尿脓毒血症,ASB是第一次菌血症。
■794名中位随访时间为47个月的患者中的七百十例被纳入。平均年龄为35.5±12岁。81名患者(11.4%)在中位25天发展为ASB(IQR10,134.5)。53％和4.9％的ASB发作是超广谱β-内酰胺酶（ESBL）阳性和碳青霉烯类耐药生物，分别。随访中有18例（32.1％）早期ASB（<3个月）和5例（20％）晚期ASB患者发生UTI。55%的早期ASB发作和16%的晚期ASB发作得到了治疗，与未经治疗的ASB发作相比，发生UTI的风险没有显着差异。
■在我们的队列中，ASB作为首次细菌尿发作的发生率为11.4％，有显著的抗菌素耐药性。女性性别,移植前UTI,移植物功能延迟与ASB的发展独立相关。早期或晚期ASB发作的治疗均未降低UTI发展的风险。
■包括2009年至2018年连续的KTR，没有阻塞性尿路病的临床或放射学证据。ASB后尿路感染（UTI）定义为膀胱炎的发生，肾盂肾炎,或者尿脓毒血症,ASB是第一次菌血症。
■794名中位随访时间为47个月的患者中的七百十例被纳入。平均年龄为35.5±12岁。81名患者(11.4%)在中位25天发展为ASB(IQR10,134.5)。53％和4.9％的ASB发作是超广谱β-内酰胺酶（ESBL）阳性和碳青霉烯类耐药生物，分别。随访中有18例（32.1％）早期ASB（<3个月）和5例（20％）晚期ASB患者发生UTI。55%的早期ASB发作和16%的晚期ASB发作得到了治疗，与未经治疗的ASB发作相比，发生UTI的风险没有显着差异。
■在我们的队列中，ASB作为首次细菌尿发作的发生率为11.4％，有显著的抗菌素耐药性。女性性别,移植前UTI,移植物功能延迟与ASB的发展独立相关。早期或晚期ASB发作的治疗均未降低UTI发展的风险。
