Kidney Transplantation
Conditions
Keywords
Urinary tract infection, Multidrug resistant bacteria, Candiduria, Epidemiology, Graft rejection, Solid organ transplantation
Brief summary
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
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.
Interventions
OTHERNo intervention
No intervention
Sponsors
Merck Sharp & Dohme LLC
Poitiers University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of UTI due to MDR bacteria | Day 0 to 2 years | Proportion of MDR bacteria compared to other bacteria found in urinalysis of symptomatic KIT patients |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Risk factors for MDR UTI | Day 0 to 2 years | Comparison of demographic and clinical characteristic of patients who develop an MDR versus a non-MDR UTI |
| Carbapenem use to treat UTI | Day 0 to 2 years | Proportion of patients who received carbapenem for UTI treatment |
| Coherence between antibiotic protocol and treatment received to treat UTI | Day 0 to 2 years | Proportion of patients who received carbapenem while responsible bacteria was susceptible to other antibiotics |
| UTI relapse frequency | Day 0 to 2 years | Proportion of patients with at least one relaspe of UTI with the same bacteria |
| Epidemiology of UTI in KIT recipients | Day 0 to 2 years | Frequency of each bacteria or yeasts responsible for UTI |
| Assessment of kidney function during the observation period | Day 0 to 2 years | Difference between the initial kidney function (MDRD) and the final kidney function at the end of the observation period |
| Graft outcome | Day 0 to 2 years | Number of patients needed a dialysis |
| Patients outcome | Day 0 to 2 years | Number of deaths |
| UTI recurrence frequency with a different micororganism | Day 0 to 2 years | Proportion of patients with more than one UTI during the study period |
Countries
France
Contacts
Primary ContactIsabelle PIRONNEAU
Backup ContactFrançois ARRIVE
Outcome results
None listed