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Urinary tract infection in renal transplant recipients

Carlos AQ Santos, MD, MPHS
Daniel C Brennan, MD, FACP
Section Editors
Barbara Murphy, MB, BAO, BCh, FRCPI
Kieren A Marr, MD
Deputy Editors
Albert Q Lam, MD
Sheila Bond, MD


Urinary tract infection (UTI) is the most common infection after kidney transplantation [1-4]. UTI is associated with the development of acute cellular rejection, impaired allograft function, allograft loss, and death [2,4-7]. Morbidity and mortality from UTI can be caused by recurrent and/or severe sepsis.

This topic reviews the definitions, epidemiology, microbiology, clinical manifestations, diagnosis, treatment, and prevention of bacterial UTI in kidney transplant recipients. UTI in the general population and among end-stage renal disease (ESRD) patients is discussed elsewhere. (See "Acute uncomplicated cystitis and pyelonephritis in women" and "Approach to the adult with asymptomatic bacteriuria" and "Recurrent urinary tract infection in women" and "Non-access-related infections in chronic dialysis patients", section on 'Genitourinary infection'.)


We use the following definitions when discussing asymptomatic bacteriuria and UTI in renal transplant recipients [3,4,7]:

Asymptomatic bacteriuria in the transplant population is defined by the presence of >105 bacterial colony forming units per milliliter (CFU/mL) of urine on urine culture with no local or systemic symptoms of UTI.

Uncomplicated UTI is the presence of >105 CFU/mL on urine culture with local urinary symptoms, such as dysuria, frequency, or urgency, but no systemic symptoms, such as fever or allograft pain.

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Literature review current through: Nov 2017. | This topic last updated: Jul 19, 2016.
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