Infecções do trato urinário no primeiro ano após transplante renal
DOI:
https://doi.org/10.31053/1853.0605.v80.n4.41244Palavras-chave:
infecções, hospedeiro imunocomprometido, transplante de rim, infecções urináriasResumo
Introdução: As infecções do trato urinário (ITUs) são as infecções mais comuns em pacientes transplantados renais (TR). O objetivo principal foi determinar as características clínicas e microbiológicas das ITUs que ocorrem durante o primeiro ano após a TR.
Métodos: Estudo de coorte retrospectivo que incluiu pacientes maiores de 18 anos que receberam TR entre 2009 e 2020 em dois hospitais da cidade de Córdoba. Os pacientes foram acompanhados durante o primeiro ano após o transplante por meio de registro em prontuário e analisados aqueles que apresentaram pelo menos um episódio de ITU.
Resultados: Durante o período do estudo, foram realizados 568 TRs, dos quais 207 (36,4%) tiveram pelo menos um episódio de ITU. No total, houve 419 episódios de ITU, 6 (1,4%) episódios de ITU polimicrobiana, portanto, um total de 426 microrganismos foram identificados nas culturas de urina. Do total de episódios, 206 (49,2%) ocorreram entre 31 e 180 dias pós-transplante. O principal agente etiológico foi E. coli com 225 isolados (52,8%) seguido de Klebsiella sp. com 94 (22,1%). 52,1% de todos os episódios foram causados por microrganismos multirresistentes (MMR). Entre os isolados de E. coli, 94 (41,8%) eram MMR. O principal fator de risco associado à ITU por MMR foi história de ITUs recorrentes (RR=1,62; IC 95%=1,29-2,02; p<0,001) e o único fator de proteção foi o uso de basiliximabe como indução. (RR=0,78 ; IC95%=0,64-0,94; p=0,012).
Conclusão: ITUs ocorreram em mais de um terço dos pacientes transplantados renais, sendo pouco mais da metade causadas por MMR.
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