尿路感染对肾移植患者异体移植结果的影响。

IF 1.3 Q3 UROLOGY & NEPHROLOGY
Rahul Sai Gangula, Mahesh Eshwarappa, R Rajashekar, Hamsa Reddy, Pooja Prakash Prabhu, Gireesh M Siddaiah, Gurudev Konana Chennabasappa, Lia Sara Anish, Yousuff Mohammad
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引用次数: 0

摘要

背景:尿路感染(UTI)是导致移植物功能障碍的第二大常见原因,发病率高,且与移植物和患者存活率低有关。本研究旨在评估肾移植后UTI与移植物预后之间的关系:我们研究了 2010 年 1 月至 2022 年 12 月间接受肾移植手术的患者中,UTI 对移植物预后的影响。研究对象包括 349 例肾移植手术,其中 74 例发生了 140 次 UTI 事件。根据UTI发作次数,将患者分为三组:在 349 名受者中,275 人(74.4%)未发生 UTI,47 人(18.8%)发生非复发性 UTI(NR-UTI),27 人(6.8%)发生复发性 UTI(R-UTI)。Kaplan-Meier 生存分析显示,KT 后 UTI 状态是影响移植物存活率、死亡剪除移植物存活率和随访 5 年后患者存活率的重要因素(对数秩,P < 0.001)。与随访 5 年后未发生 UTI 相比,R-UTI 与极差的移植物存活率和患者存活率相关(危险比 [HR],1.506;95% 置信区间 [CI],1.233-1.840;P < 0.001;HR,1.529;95% 置信区间 [CI],1.227-1.905;P = 0.001)。R-UTI更可能与对硝基呋喃妥因(RR,2.753;95% CI,1.257-6.032;P = 0.01)和碳青霉烯类(RR,2.064;95% CI,0.988-4.314;P = 0.05)耐多种药物的革兰氏阴性菌(肺炎克雷伯菌或大肠埃希菌)有关:结论:与未发生UTI相比,R-UTI与5年随访后较差的移植物和患者预后有关,而NR-UTI与较差的移植物和患者长期预后有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of urinary tract infection on the outcome of the allograft in patients with kidney transplantation.

Background: Urinary tract infections (UTIs) are the second most common cause of graft dysfunction, accounting for significant morbidity, and are associated with poor graft and patient survival. This study aimed to assess the association between post-renal transplant UTI and graft outcomes.

Methods: We examined the effect of UTIs on graft outcomes in patients who underwent renal transplantation surgery between January 2010 and December 2022. The study population included 349 renal transplantations, of which 74 experienced 140 UTI events. Based on the number of UTI episodes, patients were categorized into three groups.

Results: Of the 349 recipients, 275 (74.4%) had no UTI, 47 (18.8%) had non-recurrent UTIs (NR-UTIs), and 27 (6.8%) had recurrent UTIs (R-UTIs). Kaplan-Meier survival analysis showed that post-KT UTI status was a significant factor in graft survival, death-censored graft survival, and patient survival after a follow up of 5 years (log rank, P < 0.001). R-UTIs were associated with very poor graft survival and patient survival when compared with no UTI after a follow up of 5 years (hazard ratio [HR], 1.506; 95% confidence interval [CI], 1.233-1.840; P < 0.001 & HR, 1.529; 95% CI, 1.227-1.905; P = 0.001). R-UTIs were more likely to be associated with multi-drug resistant Gram-negative organisms (Klebsiella pneumonia or Escherichia coli) with resistance to nitrofurantoin (RR, 2.753; 95% CI, 1.257-6.032; P = 0.01) and carbapenem (RR, 2.064; 95% CI, 0.988-4.314; P = 0.05).

Conclusion: Compared to no UTI, R-UTIs were associated to worse graft and patient outcomes after a follow-up of 5 years, whereas NR-UTIs were associated with poor graft and patient outcomes in the long term.

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来源期刊
CiteScore
2.20
自引率
16.70%
发文量
208
审稿时长
16 weeks
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