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Erschienen in: Pediatric Nephrology 6/2019

28.02.2019 | Brief Report

Asymptomatic bacteriuria in pediatric kidney transplant recipients: to treat or not to treat? A retrospective study

verfasst von: Stéphanie Bonnéric, Anne Maisin, Theresa Kwon, Georges Deschênes, Olivier Niel

Erschienen in: Pediatric Nephrology | Ausgabe 6/2019

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Abstract

Background

Urinary tract infections (UTI) are common infectious complications in kidney transplant recipients (KTR); asymptomatic bacteriuria (AB) is also frequent. It is unclear whether treatment of AB reduces subsequent UTI in KTR; no guideline is available in pediatric KTR. In this retrospective study, we analyzed the incidence of AB in pediatric KTR and the impact of screening and treating AB on the onset of subsequent UTI.

Methods

Thirty-seven pediatric patients were included. Inclusion criteria were the occurrence of one or more episodes of AB between 2 and 24 months post-renal transplantation. Primary outcome was the cumulative incidence of acute pyelonephritis (APN) or lower urinary tract infections (LUTI) occurring between 2 and 24 months post-renal transplantation.

Results

Thirty-seven patients presented 171 AB episodes. One hundred sixty-four AB episodes were untreated (95.9%); among them, 150 episodes (91.5%) were not followed by a clinical infection. Ten episodes (6.1%) led to APN, and 4 (2.4%) to LUTI. There were 53 episodes of APN: 10 (18.9%) after untreated AB and 43 (81.1%) de novo. There were 11 episodes of LUTI: 4 (36.4%) after untreated AB and 7 (63.6%) de novo. Multi-drug resistant bacteria were present in 27% of the patients and in 20% of patients with pre-existing uropathy.

Conclusions

Our results are not in favor of systematic treatment of AB in pediatric KTR. Notably, limitation of antibiotic treatment is an urgent and important health issue in this population, in order to reduce multi-drug resistant bacteria emergence.
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Metadaten
Titel
Asymptomatic bacteriuria in pediatric kidney transplant recipients: to treat or not to treat? A retrospective study
verfasst von
Stéphanie Bonnéric
Anne Maisin
Theresa Kwon
Georges Deschênes
Olivier Niel
Publikationsdatum
28.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 6/2019
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-019-04204-y

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