Title:Investigation of Nosocomial Urinary Tract Infections Post Transplantation,
Main Pathogens, and Sensitivity Tests
Volume: 19
Issue: 7
Author(s): Zahra Tolou Ghamari*
Affiliation:
- Nutrition and Food Security Research Center, Deputy of Research and Technology, Isfahan University of Medical Sciences,
Isfahan, Iran
Keywords:
Urianry tract infection, nosocomial, Candida, Escherichia coli, Klebsiella pneumonia, recipients, organ transplantation.
Abstract:
Background: Regarding end-stage organ disease, transplantation is recommended as the
best therapeutic management. After organ transplantation, the incidence of nosocomial urinary tract
infections (NUTIs) due to multidrug-resistant Gram-negative bacilli increases.
Aim: The study aimed to investigate NUTIs post-transplantation, the main pathogens involved, and
sensitivity tests conducted in a tertiary hospital in Isfahan, Iran.
Methods: A retrospective survey on patients admitted to a tertiary hospital in Isfahan (Alzahra), Iran,
was performed between 27 March, 2017, and 9 February, 2022. The information recorded included
the date of infection, date of hospitalization, gender, age, type of pathogens, and resistance or sensitivity
to antibiotics.
Results: 73 kidney transplant recipients (61% females) with a mean age of 43. 2 ± 15.1 years were
included. Within this population involving both genders, the main pathogens involved in NUTIs were
as follows: Escherichia coli (30%), Klebsiella pneumonia (19%), Candida albicans and non-albicans
(14%), Enterococcus faecalis (12%), Enterobacteriaceae (8%), Pseudomonas aeruginosa (6%),
Staphylococcus spp. (6%), Acinetobacter baumannii (4%), and Streptococcus spp. (4%). Antibiotic
susceptibility testing showed the most sensitivity of isolates against amikacin (n=29; 66%), meropenem
(n= 28; 64%), piperacillin/tazobactam (n=26; 54%), cefepime (n= 25; 40%), ceftazidime (n=
27; 30%), ciprofloxacin (n= 40; 18%), and co-trimoxazole (n= 29; 10%).
Conclusion: Escherichia coli, Klebsiella pneumonia, and Candida spp. were the major causes of
NUTIs within the studied organ-transplanted recipients. Amikacin, meropenem, and piperacillin/
tazobactam have shown more than 50% sensitivity against isolates. Further evidence-based pharmacotherapy
investigations associated with the different spectrum antibiotics and overall antimicrobial
success rate is recommended to be advantageous.
