1674 - Epidemiology of Urinary Tract Infections in the Renal Transplant Population in a Large Urban Midwestern Hospital: A Retrospective Cohort Study

Background: Renal Transplant Recipients (RTR) are at high risk for Urinary Tract Infections (UTIs).  However, the best empiric option for treatment is not well defined, because the prevalence of extended spectrum beta-lactamase (ESBL) Enterobacteriaceae and carbapenem resistant Enterobacteriaceae (CRE).  The primary purpose of this study was to describe the prevalence of multidrug resistant UTIs in a contemporary cohort of RTR at a large Midwestern tertiary care hospital.  Secondary outcomes evaluated frequency of key symptoms and physical exam findings, as well as characteristics of patients who developed multidrug resistant organisms, morbidity, and mortality.

Methods: This was a single-center retrospective cohort study.  Patients were included if they were 18 years or older and underwent their transplant between July 11, 2019 and November 26, 2018.    Statistical analysis was performed using Fischer’s Exact T-test for comparison of the patients with and without ESBL UTIs.  Significance was defined by a p< 0.05

Results: Two hundred fifty-two patients were evaluated (median age 54.4, 38.3% female gender), 36 patients developed UTIs, and no patients had CRE organisms.  ESBL UTI prevalence was 7/252 (2.8%) among the total RTR population and 7/36 (19.4%) among the population of RTR who developed UTIs.  Mortality rates did not differ significantly between patients with and without ESBL UTI (0% and 6.9%, respectively, p=.489) (Table 1).  Additional clinical characteristics of the patients that developed ESBL UTIs were also obtained (Table 2).Table 1: Comparison of non-ESBL UTI and ESBL UTI
Table 2: Characteristics of Patients with ESBL UTI


Conclusion: Prevalence of ESBL UTIs among RTR are low at a tertiary Midwestern hospital.