Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients: a survey of current practice in Europe.

Coussement, Julien; Maggiore, Umberto; Manuel, Oriol; Scemla, Anne; López-Medrano, Francisco; Nagler, Evi V; Aguado, José María; Abramowicz, Daniel (2018). Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients: a survey of current practice in Europe. Nephrology, dialysis, transplantation, 33(9), pp. 1661-1668. Oxford University Press 10.1093/ndt/gfy078

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Background Asymptomatic bacteriuria is frequent in kidney transplant recipients (KTRs). However, there is no consensus on diagnosis or management. We conducted a European survey to explore current practice related to the diagnosis and management of asymptomatic bacteriuria in adult KTRs. Methods A panel of experts from the European Renal Association-European Dialysis Transplant Association/Developing Education Science and Care for Renal Transplantation in European States working group and the European Study Group for Infections in Compromised Hosts of the European Society of Clinical Microbiology and Infectious Diseases designed this cross-sectional, questionnaire-based, self-administered survey. Invitations to participate were e-mailed to European physicians involved in the care of KTRs. Results Two hundred and forty-four participants from 138 institutions in 25 countries answered the survey (response rate 30%). Most participants [72% (176/244)] said they always screen for asymptomatic bacteriuria in KTRs. Six per cent (15/240) reported never treating asymptomatic bacteriuria with antibiotics. When antimicrobial treatment was used, 24% of the participants (53/224) said they would start with empirical antibiotics. For an episode of asymptomatic bacteriuria caused by a fully susceptible microorganism and despite no contraindications, a majority of participants (121/223) said they would use a fluoroquinolone (n = 56), amoxicillin/clavulanic acid (n = 38) or oral cephalosporins (n = 27). Conclusions Screening for and treating asymptomatic bacteriuria are common in KTRs despite uncertainties around the benefits and harms. In an era of antimicrobial resistance, further studies are needed to address the diagnosis and management of asymptomatic bacteriuria in these patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension

ISSN:

0931-0509

Publisher:

Oxford University Press

Language:

English

Submitter:

Uyen Huynh-Do

Date Deposited:

01 Oct 2019 12:31

Last Modified:

23 Oct 2019 10:50

Publisher DOI:

10.1093/ndt/gfy078

PubMed ID:

29635410

Additional Information:

Collaborators: Uyen Huynh-Do

BORIS DOI:

10.7892/boris.131737

URI:

https://boris.unibe.ch/id/eprint/131737

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