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Urology, Nephrology and Andrology International

Volume  5, Issue 1, January-June 2020, Pages 11-16
 

Original Article

Spectrum of Infections in Post Renal Transplant Patients

Pramod GR, Renuka S, Prashanth GK, Limesh M

1,Assistant Professor, Father Muller Medical College and Hospital, Mangalore, Karnataka 575002, India. 2Professor and Head, 3,4Assistant Professor, Department of Nephrology, St. Johns Medical College and Hospital, Bangalore, Karnataka 560034, India.

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DOI: http://dx.doi.org/10.21088/unai.2456-5016.5120.2

Abstract

Introduction: Infections remain a major cause of morbidity and mortality in transplant recipients. Knowledge about the chronology of infections, their incidence and their mortality rates helps in delivering a better care to the transplant patients. Patients and Methods: This is prospective observational study was done between January 2017 and December 2018 and included all renal allograft recipients who suffered from an episode of infection. We analyzed spectrum of infection, the time of onset of infection and its influence on allograft function. Results: A total
of 30 patients were included. Majority of patients (22) were males (73.3%) and 8(26.7%) patients were females. Mean age at presentation in our study was 38 + 12.8 years. A total of 19(63.3%) underwent live related renal transplants and mother was the most common donor. Eleven(36.7%) were deceased donor transplants. Commonest cause of native kidney disease was presumed Chronic interstitial nephritis in eleven( 36.7%) followed by presumed Chronic glomerulonephritis in seven(23.3%). Induction was given in fourteen patients and commonly used agent was basiliximab(10 cases). A total of 55 episodes of infection were recorded in the 30 cases included. 56.6% cases had more than one episode of infection and on an average every patient had suffered from ~1.9 infection episodes during post transplantation period. Bacterial aetiology was most common followed by viral. Commonest infection was UTI and mean onset of infection was seen at twenty eight and half monthspost transplant.Infection leading to precipitation of graft dysfunction was seen in 14 cases(46.7%)and among them 4 (13.3%) patients had rejection. On follow up, 10 patients (71.4%) improved and 4(28.6%) patients died. Conclusion: Bacterial aetiology for infection was more frequent than viral. UTI was the most common infection seen. Mean onset of infection was seen at twenty eight and half months after transplant.Graft dysfunction was seen in 46.7% cases. Mortality rate was 28.6% and this had a direct relation with the number of infective episodes. Patients with higher infective episodes had greater mortality.

Keywords: Renal Transplant; Immunosuppression and Infections; Uti In Renal Transplant.
 


Corresponding Author : Renuka S