2026-04-13T06:48:53Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1870632026-01-14T12:34:05Zcom_2072_1057col_2072_478916col_2072_478917

00925njm 22002777a 4500 dc Sabé, Nuria author Maristany Bosch, Marta author Tuells, Manel author Favà Buch, Alexandre author Melilli, Edoardo author Tubau, Fe author Cruzado, Josep Ma. author Carratalà, Jordi author 2022-06-27T10:46:15Z 2022-06-27T10:46:15Z 2022-06-02 2022-06-27T07:57:53Z Acute graft pyelonephritis (AGP) is the leading cause of bloodstream infection in kidney transplant (KT) recipients. The prevalence of urinary tract infections caused by multidrug-resistant (MDR) Gram-negative bacilli is increasing. This 14-year prospective observational study sought to determine the clinical characteristics, risk factors, and outcomes of AGP with bacteremia due to MDR Gram-negative bacilli. Overall, 278 episodes of AGP with bacteremia due to MDR Gram-negative and non-MDR Gram-negative bacilli were identified and compared in 214 KT recipients; MDR Gram-negative bacilli were the cause in 28.4%. Overall 30-day mortality was low (1.1%). Risk factors independently associated with AGP due to MDR Gram-negative bacilli were male sex (OR 3.08; 95%CI 1.60-5.93), previous episode of bacteremic AGP (OR 2.11, 95%CI 1.09-4.09), prior antibiotic therapy in the preceding month (OR 2.47, 95%CI 1.33-4.57), and nosocomial acquisition (OR 2.03, 95%CI 1.14-3.62). Forty-three percent of MDR Gram-negative episodes received inappropriate empirical antibiotic therapy. The risk factors identified in this study may help physicians when selecting empirical antibiotic treatment for AGP. Previous antibiotic use was the main modifiable factor. Its presence highlights the importance of avoiding unnecessary antibiotics in order to bring down the high rates of MDR Gram-negative bacilli infections in this population. Trasplantament renal Infeccions del tracte urinari Kidney transplantation Urinary tract infections Risk Factors and Outcomes of Acute Graft Pyelonephritis with Bacteremia Due to Multidrug-Resistant Gram-Negative Bacilli among Kidney Transplant Recipients