Urinary Tract Infections in Kidney Transplant Recipients

Study Overview
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Brief Summary
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The purpose of this study is to better estimate the prevalence of urinary tract infections (UTI) in kidney transplant (KIT) recipients, and especially multidrug resistant (MDR) bacteria. KIT recipients have a higher risk of UTI over the 6 first months following the transplantation. Urine culture was done in a city lab or at hospital. Current data on bacteriuria and candiduria lead mostly to hospital data that are incomplete..

Detailed Description
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The risk of UTI after a kidney transplantation is higher than in the general population. MDR bacteria, such as extended spectrum betalactamase (ESBL)-producing enterobacteriaceae or MDR Pseumomoas aeruginosa are emerging threats due to antibiotic selective pressure. Epidemiological data are mostly data from hospital laboratories that do not show a complete overview of the current situation. In addition, the different centers which participated to this study received before the beginning of the study a protocol to avoid carbapenem use. The main objective of this study is to assess the prevalence of MDR bacteria in an adult population of KIT recipients. Through this study, the management of UTI in KIT recipients will be improved. Data on bacteria or yeasts responsible for UTI (identification, resistance profile), antibiotic use, patients' outcome, and graft outcome will be collected.

Official Title
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Urinary Tract Infections in Kidney Transplant Recipients : an Observational Cohort

Conditions
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Kidney Transplantation

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion criteria Age ≥ 18 year-old Kidney transplanted for less than 5 years First symptomatic episode of UTI with bacteria or yeast To have a health insurance Exclusion criteria Asymptomatic bacteriuria or candiduria Protected people Pregnant women -> 2 bacteria in the urinalysis without external or internal urinary catheter

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: No intervention|No intervention|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of UTI due to MDR bacteria | Proportion of MDR bacteria compared to other bacteria found in urinalysis of symptomatic KIT patients | Day 0 to 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Epidemiology of UTI in KIT recipients | Frequency of each bacteria or yeasts responsible for UTI | Day 0 to 2 years | 
| Risk factors for MDR UTI | Comparison of demographic and clinical characteristic of patients who develop an MDR versus a non-MDR UTI | Day 0 to 2 years | 
| Carbapenem use to treat UTI | Proportion of patients who received carbapenem for UTI treatment | Day 0 to 2 years | 
| Coherence between antibiotic protocol and treatment received to treat UTI | Proportion of patients who received carbapenem while responsible bacteria was susceptible to other antibiotics | Day 0 to 2 years | 
| UTI relapse frequency | Proportion of patients with at least one relaspe of UTI with the same bacteria | Day 0 to 2 years | 
| UTI recurrence frequency with a different micororganism | Proportion of patients with more than one UTI during the study period | Day 0 to 2 years | 
| Assessment of kidney function during the observation period | Difference between the initial kidney function (MDRD) and the final kidney function at the end of the observation period | Day 0 to 2 years | 
| Graft outcome | Number of patients needed a dialysis | Day 0 to 2 years | 
| Patients outcome | Number of deaths | Day 0 to 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Urinary tract infection, Multidrug resistant bacteria, Candiduria, Epidemiology, Graft rejection, Solid organ transplantation