February 23, 2012

Outcome of treated and untreated asymptomatic bacteriuria in renal transplant recipients.


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Asymptomatic bacteriuria in post-kidney transplant recipients is very common and may or may not be treated.  The need for therapy is guided by a number of factors including the presence of pyuria, the time post-transplant, immunosuppression, and renal function.  However, therapy is commonly instituted and very often leads to antimicrobial resistance.  Whether treatment of asymptomatic bacteriuria prevents ascending disease is largely unknown.  In this retrospective review 334 episodes of asymptomatic E.coli and Enterococcus infections in 77 kidney transplant patients were analysed.  Spontaneous bacterial clearance occurred in a large proportion (59%) of untreated episodes.  There was no significant difference between the development of symptomatic infection in treated and untreated episodes.  Although this study has small numbers of patients, it lends support to not treating every episode of asymptomatic bacteriuria.

Transplant Infectious Disease

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