Medina-Polo, José; Falkensammer, Eva; Köves, Béla; Kranz, Jennifer; Tandogdu, Zafer; Tapia, Ana María; Cai, Tommaso; Wagenlehner, Florian M E; Schneidewind, Laila; Bjerklund Johansen, Truls Erik (2024). Systematic Review and Meta-Analysis Provide no Guidance on Management of Asymptomatic Bacteriuria within the First Year after Kidney Transplantation. Antibiotics, 13(5) MDPI 10.3390/antibiotics13050442
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(1) Background: Urinary tract infections (UTIs) are among the most frequent complications in kidney transplant (KT) recipients. Asymptomatic bacteriuria (ASB) may be a risk factor for UTIs and graft rejection. We aimed to evaluate available evidence regarding the benefit of screening and treatment of ASB within the first year after KT. (2) Evidence acquisition: A systematic literature search was conducted in MEDLINE, the Cochrane Library CENTRAL and Embase. Inclusion criteria were manuscripts in English addressing the management of ASB after KT. The PICO questions concerned Patients (adults receiving a KT), Intervention (screening, diagnosis and treatment of ASB), Control (screening and no antibiotic treatment) and Outcome (UTIs, sepsis, kidney failure and death). (3) Evidence synthesis: The systematic review identified 151 studies, and 16 full-text articles were evaluated. Seven were excluded because they did not evaluate the effect of treatment of ASB. There was no evidence for a higher incidence of lower UTIs, acute pyelonephritis, graft loss, or mortality in patients not treated with antibiotics for ASB. Analysis of comparative non-randomized and observational studies did not provide supplementary evidence to guide clinical recommendations. We believe this lack of evidence is due to confounding risk factors that are not being considered in the stratification of study patients.
Item Type: |
Journal Article (Review Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology |
UniBE Contributor: |
Schneidewind, Laila |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2079-6382 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
29 May 2024 15:14 |
Last Modified: |
30 May 2024 15:51 |
Publisher DOI: |
10.3390/antibiotics13050442 |
PubMed ID: |
38786170 |
Uncontrolled Keywords: |
antibiotics asymptomatic bacteriuria (ASB) graft rejection kidney failure kidney transplant meta-analysis systematic review urinary tract infection |
BORIS DOI: |
10.48350/197073 |
URI: |
https://boris.unibe.ch/id/eprint/197073 |
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