The prevalence of urinary tract infection in kidney transplant recipients at Kenyatta national hospital

Abstract

Introduction Urinary tract infections form the largest percentage of post kidney transplantation infections making up to 47% of all infections. These UTIs are more likely to be clinically asymptomatic compared to patients not on immunosuppressive therapy. UTI in this group is often associated with serious morbidity and even death. The prevalence and microbial patterns vary between centers. There is no known local data describing the prevalence and patterns in our set up. Objective: To determine the prevalence of bacterial and fungal UTIs and their clinical and microbiologic patterns among kidney transplant recipients at Kenyatta National Hospital. Study design: Cross sectional descriptive study Study population: Kidney recipients, aged eighteen years and above, attending the follow up clinic at KNH Methodology: Ninenty nine patients were recruited after an informed written consent. Clinical data was retrieved from the participants’ files. Clinical assessment for UTI was carried out via history and physical examination. Microscopy, leucocyte esterase, nitrite and culture analysis was carried out on MSSU specimen. Statistical analysis was carried out using SPSS version 18.0 software. Results: Twenty one percent of participants had UTI. Females were affected more than men, 38.5% and 15% respectively. 86% of the UTIs were asymptomatic. 12% of UTI were culture positive. Gram negative bacteria were the commonest, with E. coli making the highest percentage (58%). 40% of Gram negative bacilli were ESBL positive. Conclusion: The prevalence of UTI in our population was high with a prevalence of 21%. The majority of the UTIs were asymptomatic and involved a higher percentage of females. Gram negative bacteria were the majority with Escherichia coli being the most isolated. Emergence of Extended Spectrum Beta Lactamase bacteria, a matter of grave concern was noted.