Investigation of Nosocomial Urinary Tract Infections Post Transplantation, Main Pathogens, and Sensitivity Tests

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. Aims: 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.