Zusammenfassung
Hintergrund
Harnwegsinfekte sind eine häufige bakterielle Komplikation nach Nierentransplantation bei Erwachsenen und Kindern. Es existieren jedoch nur wenige Daten bei pädiatrischen Patienten in der Frühphase nach Nierentransplantation. Ziel dieser Studie war es, Häufigkeit, Risikofaktoren und Einfluss auf die Kurzzeit Transplantatfunktion von Harnwegsinfekten in der späteren Phase nach Nierentransplantation zu untersuchen.
Patienten und Methoden
Im Zeitraum von 1997 bis 2000 wurden 47 Kinder, die 58 Transplantate erhielten, untersucht. Sie waren zum Zeitpunkt der Analyse seit 3,5 Jahren transplantiert. Die Definition eines Harnwegsinfektes war eine signifikante Bakteriurie (>105 Keime/ml) und Symptome.
Ergebnisse
15 (32%) von den 47 Patienten hatten 1 bis 7 Harnwegsinfekte im Untersuchungszeitraum. Insgesamt wurden in den 3 Jahren 35 Harnwegsinfekte dokumentiert. Das mediane Alter bei Diagnose war 5,5 Jahre (1,8–24,2 Jahre). Geschlecht, Organquelle, Immunsuppression und Grundkrankheit hatten keinen Einfluss auf die Häufigkeit der Harnwegsinfekte. Während der Infektion kam es zu einem signifikantem Kreatininanstieg, während das C-reaktive Protein nicht anstieg.
Schlussfolgerung
Unsere Ergebnisse zeigen, dass Harnwegsinfekte auch nach der Frühphase nach Nierentransplantation ein häufiges aber meist harmloses Ereignis sind. Um Fragen über die Langzeitfolgen dieser Infekte auf die Transplantatfunktion zu beantworten, sind ausgedehntere Untersuchungen notwendig.
Summary
Background
Urinary tract infection is a frequent bacterial complication after renal transplantation in adults and children, however there are only very limited data on children beyond the early post-transplant period. In this study we investigated urinary tract infections in pediatric outpatients who had received transplants more than six months previously. Incidence, risk factors and impact on short-term graft function were analyzed.
Methods
47 children who had received a total of 58 allografts were analyzed between 1997 and 2000. At the time of analysis they had had their transplants for an average of 3.5 years (range 0.5–9.4). Urinary tract infection was defined as the presence of both significant bacteriuria (>105 CFU/ml) and symptoms.
Results
Of the 47 patients, 15 (32%) had from 1 to 7 urinary tract infections each. In total 35 infections were recorded. Median age at urinary tract infection was 5.5 years (range 1.8–24.2). Gender, donor source, immunosuppression and underlying disease (urologic vs. nonurologic) did not influence the incidence of urinary tract infection. Creatinine but not C-reactive protein rose significantly during the infection.
Conclusions
Our data suggest that urinary tract infection remains a frequent but mostly benign complication in the pediatric transplant population, even beyond the early post-transplant period. More extended studies are needed to assess the long-term effects on graft function.
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Mueller, T., Resinger, C., Ruffingshofer, D. et al. Urinary tract infections beyond the early post-transplant period in pediatric renal graft recipients. Wien Klin Wochenschr 115, 385–388 (2003). https://doi.org/10.1007/BF03040357
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DOI: https://doi.org/10.1007/BF03040357