PDF(Pubmed)
Abstract：
Background Current literature suggests that anywhere from 2.9-27% of renal transplant recipients (RTR) will develop recurrent urinary tract infections (UTIs) (≥2 UTIs over six months or ≥3 UTIs over 12 months). Recurrent UTIs are of particular importance to RTR given its increased risk for allograft fibrosis and overall patient survival. Alternative solutions are needed for the management of recurrent UTIs, especially given the vulnerability of RTR to UTIs. We hypothesize that bladder washout (BW) reduces the incidence and recurrence of UTIs in RTR. Methods This is a retrospective study evaluating the utility of BW procedures on RTR diagnosed with recurrent UTIs between December 2013 and July 2021 at a single center. Results A total of 106 patients were included in the study with a total of 118 BW performed. 69% of patients were successfully treated with BW, meaning they no longer met the criteria for recurrent UTIs (<1 UTI) in the six-month post-BW period. The mean number of UTIs was 2.76 (range 2-7) before the BW and 1.16 (range 0-5) after the BW. On average, there were 1.60 fewer UTIs in the post-BW period compared to the pre-BW period (p<0.0001). There is no statistically significant difference in success rates stratified by bacterial class (p=1) or antimicrobial resistance class (p=0.6937). Conclusion BW decreased the incidence of UTIs in the six-month post-operative period as nearly 70% of patients did not have UTI recurrence. This data provides evidence that BW may have utility in transplant recipients with recurrent UTIs. We hope this will stimulate further prospective randomized studies in this area.
摘要：
背景目前的文献表明，2.9-27％的肾移植受者（RTR）会发生复发性尿路感染（UTI）（超过6个月≥2个UTI或超过12个月≥3个UTI）。考虑到其增加的同种异体移植物纤维化和患者总体存活率的风险,复发性UTI对RTR特别重要。经常性尿路感染的管理需要替代解决方案，特别是考虑到RTR对UTI的脆弱性。我们假设膀胱冲洗（BW）降低了RTR中UTI的发生率和复发率。方法这是一项回顾性研究，评估2013年12月至2021年7月在单个中心诊断为复发性UTI的RTR的BW程序的实用性。结果共纳入106例患者，共118例BW。69％的患者成功接受BW治疗，这意味着他们在BW后六个月内不再符合复发性UTI（<1UTI）的标准。在BW之前，UTI的平均数量为2.76（范围2-7），在BW之后为1.16（范围0-5）。平均而言,与BW前相比，BW后时期的UTI减少了1.60例（p<0.0001）。按细菌类别（p=1）或抗菌素耐药性类别（p=0.6937）分层的成功率没有统计学上的显着差异。结论BW降低了术后6个月UTI的发生率，因为近70％的患者没有UTI复发。该数据提供了证据，表明BW可能在患有复发性UTI的移植接受者中具有实用性。我们希望这将刺激该领域进一步的前瞻性随机研究。
