Table 1: Sociodemographic characteristics of study participants with and without UTI, St Paul’s Hospital Millennium medical college, Addis Ababa, Ethiopia.
Variables
|
Total (%)
|
UTI no (%)
|
No UTI no (%)
|
Bivariate analysis
|
P-value
|
Gender
|
COR
|
95%CI
|
Male
|
42(56.8)
|
5(11.9)
|
37(88.1)
|
0.848
|
0.57-11.31
|
0.419
|
Female
|
32(43.2)
|
6(18.75)
|
26(81)
|
2.09
|
1.04-8.45
|
0.253
|
Age
|
|
|
|
|
|
|
18-34
|
29(39.2)
|
4(13.8)
|
25(86.2)
|
1.42
|
0.64-14.05
|
0.338
|
35-49
|
31(41.9)
|
6(19.3)
|
25(80.6)
|
3.67
|
2.89-20.07
|
0.003
|
50-64
|
10(13.5)
|
1(10)
|
9(90)
|
3
|
2.91-10.00
|
0.914
|
Above 64
|
4(5.4)
|
0(0.0)
|
4(100)
|
0.88
|
0.58-3.27
|
0.444
|
Marital status
|
|
|
|
|
|
|
Single
|
23(31)
|
6(26.1)
|
17(74)
|
5.64
|
0.73-13.22
|
0.222
|
Married
|
30(40.5)
|
4(13.3)
|
26(86.7)
|
1.724
|
1.081-6.82
|
0.391
|
Divorced
|
12(16.2)
|
1(8.3)
|
11(91.7)
|
7
|
4.36-9.15
|
0.284
|
Widowed
|
5(6.8)
|
0(0.0)
|
5(100)
|
0.23
|
0.11-3.74
|
0.058
|
Widower
|
4(5.4)
|
0(0.0)
|
4(100)
|
8.04
|
2.05-10.09
|
0.701
|
Educational level
|
|
|
|
|
|
|
Student
|
11(14.9)
|
2(18.2)
|
10(91)
|
1
|
0.37-4.12
|
0.348
|
Diploma
|
31(41)
|
5(16)
|
26(83.9)
|
2.872
|
0.81-5.06
|
0.579
|
Degree
|
13(17.6)
|
2(15)
|
11(84.6)
|
4
|
2.01-6.19
|
0.441
|
Illiterate
|
15(20)
|
2(13)
|
13(86.7)
|
2.11
|
1.90-17.48
|
0.990
|
Above degree
|
4(5.4)
|
0(0.0)
|
4(100)
|
0.81
|
0.36-1.34
|
0.007
|
Table 2: Prevalence of UTI in related clinical variables of renal transplants recipients.
Variables
|
Total (%)
|
UTI no (%)
|
No UTI no (% )
|
Bivariate analysis
|
p-value
|
COR
|
95%CI
|
Time since transplantation
|
|
|
|
|
|
|
0-6 months
|
17(22.9)
|
3(17.6)
|
14(82.3)
|
2.29
|
0.42-2.96
|
0.391
|
7-12 months
|
19(25.7)
|
4(21)
|
15(79)
|
2.57
|
1.09-11.03
|
0.555
|
13-24 months
|
19(25.7)
|
2(10.5)
|
17(89.5)
|
0.71
|
0.54-6.38
|
0.081
|
>24 months
|
19(25.7)
|
2(10.5)
|
17(98.5)
|
1.23
|
0.98-7/11
|
0.661
|
Pre- transplant UTI history
|
|
|
|
|
|
|
Yes
|
5(6.8)
|
2(40)
|
3(60)
|
4.32
|
2.09-17.10
|
0.010
|
No
|
69(93.2)
|
9(13)
|
60(87)
|
0.51
|
0.26-2.11
|
0.997
|
Place of the transplantation
|
|
|
|
|
|
|
Local
|
54(73)
|
9(16.7)
|
45(83.3)
|
4.01
|
0.18-19.06
|
0.481
|
Abroad
|
20(27)
|
2(10)
|
18(90)
|
0.89
|
0.69-8.81
|
0.671
|
Donor’s gender
|
|
|
|
|
|
|
Male
|
40(54.1)
|
5(12.5)
|
35(87.5)
|
3.1
|
2.19-3.70
|
0.561
|
Female
|
34(45.9)
|
4(11.8)
|
30(88.2)
|
2.07
|
1.04-7.31
|
0.549
|
History of Catheterization
|
|
|
|
|
|
|
Yes
|
5(6.8)
|
1(20)
|
4(80)
|
1.90
|
1.11-11.38
|
0.001
|
No
|
69(93.2)
|
10(14.5)
|
59(85.5)
|
0.53
|
0.21-0.98
|
0.941
|
Sex donor category
|
|
|
|
|
|
|
Female to male
|
17(23)
|
2(11.8)
|
15(88.2)
|
0.23
|
0.10-1.93
|
0.234
|
Male to female
|
22(29.7)
|
5(22.7)
|
17(72.3)
|
1.09
|
1.07-13.03
|
0.306
|
Male to male
|
17(23)
|
2(11.8)
|
15(88.2)
|
0.91
|
0.54-2.41
|
0.773
|
female to female
|
18(24.3)
|
2(11.1)
|
16(88.9)
|
1
|
0.62-6.78
|
0.009
|
Table 3: Significant bacteriuria from urine culture of renal transplant recipients
Significant bacteriuria
|
Frequency(n)
|
Percent (%)
|
Yes
|
11
|
14.9
|
No
|
63
|
85.1
|
Total
|
74
|
100
|
Renal transplant recipients
|
Significant bacteriuria
|
|
Yes
|
No
|
Total
|
COR(95%CI)
|
P-value
|
Asymptomatic no (%)
|
8(22.2)
|
28(77.8)
|
36(48.7)
|
1.01(0.547-3.829)
|
0.847
|
Symptomatic no (%)
|
3(7.9)
|
35(92.1)
|
38(51.3)
|
Total no (%)
|
11(14.9)
|
63(85.1)
|
74(100)
|
Table 4: Bacterial species isolated from asymptomatic and symptomatic UTI among renal transplant recipients, St Paul’s Hospital Millennium medical college, Addis Ababa, Ethiopia.
Bacterial isolates
|
Asymptomatic RTX no (%)
|
Symptomatic RTX no (%)
|
Total (%)
|
Gram-negative
|
5(62.5)
|
0(0.0)
|
5(45.4)
|
E.coli
|
2(25)
|
0(0.0)
|
2(18.18)
|
Acinetobacter spp.
|
2(25)
|
0(0.0)
|
2(18.18)
|
P.mirabilis
|
1(12.5)
|
0(0.0)
|
1(9.1)
|
Gram-positive
|
3(37.5)
|
3(99.9)
|
6(54.6)
|
Enterococcus spp.
|
1(12.5)
|
1(33.3)
|
2(18.18)
|
CoNS
|
1(12.5)
|
1(33.3)
|
2(18.18)
|
S.aureus
|
1(12.5)
|
1(33.3)
|
2(18.18)
|
Total
|
8(72.7)
|
3(27.3)
|
11(100)
|
CoNS=Coagulase Negative Staphylococci
Table 5: Bacterial etiologic agents isolated from urine culture of renal transplants
Bacterial isolates
|
Frequency(n)
|
Percent (%)
|
Gram-Negative
|
5
|
45.4
|
E.coli
|
2
|
18.2
|
Acinetobacter spp.
|
2
|
18.2
|
P.mirabilis
|
1
|
9.1
|
Gram-positive
|
6
|
54.6
|
Enterococcus spp.
|
2
|
18.2
|
CoNS
|
2
|
18.2
|
S.aureus
|
2
|
18.2
|
Total
|
11
|
100
|
Table 6: Antibacterial susceptibility patterns of Gram-positive bacterial isolates.
Urine Culture out put
|
Antibacterial agents tested
|
VA
|
CTR
|
CHL
|
NIT
|
AMC
|
PEN
|
TET
|
SXT
|
ERY
|
CLN
|
CN
|
Bacterial isolates
|
Total
|
Pattern
|
no(%)
|
no(%)
|
no(%)
|
no(%)
|
no (%)
|
no(%)
|
no(%)
|
no(%)
|
no (%)
|
no (%)
|
no (%)
|
S. aureus
(n=2)
|
2
|
R
I
S
|
0(0)
2(100
0(0)
|
2(100)
0(0)
0(0)
|
2(100)
0(0)
0(0)
|
2(100) 0(0)
0(0)
|
1(50)
0(0)
1(50)
|
2(100
0(0)
0(0)
|
1(50)
0(0) 1(50
|
1(50) 0(0) 1(50)
|
0(0)
0(0)
2(100
|
0(0)
0(0)
2(100)
|
0(0)
0(0)
2(100)
|
CoNS
(n=2)
|
2
|
R
I
S
|
1(50)
0(0)
1(50)
|
1(50)
1(50)
0(0)
|
2(100)
0(0) 0(0)
|
2(100)
0(0)
0(0)
|
2(100
0(0)
0(0)
|
0(0)
1(50)
1(50)
|
2(100
0(0)
0(0)
|
0(0)
1(50)
1(50)
|
0(0)
2(100 0(0)
|
0(0)
0(0)
2(100)
|
2(100)
0(0)
0(0)
|
Enterococcus spp.(n=2)
|
2
|
R
I
S
|
0(0)
2(100
0(0)
|
2(100)
0(0)
0(0)
|
0(0)
1(50)
1(50)
|
0(0)
0(0)
2(100)
|
2(100
0(0)
0(0)
|
1(50)
0(0)
1(50)
|
1(50)
0(0)
1(50)
|
2(100
0(0)
0(0)
|
2(100
0(0)
0(0)
|
2(100
0(0)
0(0)
|
2(100)
0(0)
0(0)
|
Total
(n=6)
|
6
|
R
I
S
|
1(17)
4(67)
1(17)
|
5(83)
1(17)
0(0)
|
4(67)
1(17)
1(17)
|
4(67)
0(0)
2(33)
|
5(83)
0(0)
1(17)
|
3(50)
1(17)
2(33)
|
4(67)
0(0)
2(33)
|
3(50)
1(17)
2(33)
|
2(33)
2(33)
2(33)
|
2(33)
0(0)
4(67)
|
4(67)
0(0)
2(33)
|
Abbreviations: R = Resistant S = Sensitive I = Intermediate, AMC= Amoxicillin Clavulanate acid, CTR=Ceftriaxone, CHL=Chloramphenicol, CLN=Clindamycin, ERY=Erythromycin, CN=Gentamicin, NIT= Nitrofurantoin, TET=Tetracycline, SXT=Trimethoprim-Sulfamethoxazole, VA= Vancomycin, PEN =Penicillin
Table 7: Antibacterial susceptibility patterns of Gram-negative bacteria isolates.
Urine Culture out put
|
Antibacterial agents tested
|
CIP
|
TET
|
CN
|
AMC
|
CHL
|
NIT
|
SXT
|
CPM
|
CTR
|
MEM
|
DC
|
|
Bacterial isolates
|
Total
|
Pattern
|
no (%)
|
no (%
|
no(%)
|
no(%
|
no(%
|
no(%)
|
no(%
|
no(%
|
no(%
|
no(%)
|
no(%
|
|
E.coli (n=2)
|
2
|
R
I
S
|
2(100 0(0)
0(0)
|
1(50
0(0) 1(50)
|
0(0)
0(0)
2(100
|
1(50)
1(50)
0(0)
|
2(100
0(0)
0(0)
|
2(100
0(0)
0(0)
|
2(100
0(0)
0(0)
|
2(100 0(0)
0(0)
|
2(100
0(0)
0(0)
|
0(0) 2(100) 0(0)
|
1(50)
0(0)
1(50)
|
|
Acinetobacter spp.(n=2
|
2
|
R
I
S
|
2(100
0(0 0(0)
|
0(0)
0(0) 2(100
|
0(0)
0(0)
2(100
|
2(100
0(0 0(0
|
2(1000(0) 0(0)
|
2(100
0(0)
0(0)
|
2(100
0(00)
1(50)
|
1(50)
0(0) 1(50)
|
2(100
0(0)
0(0)
|
1(50)
1(50)
0(0)
|
0(0)
0(0)
2(100
|
|
P. mirabilis (n=1)
|
1
|
R
I
S
|
0(0) 0(0)
1(100
|
1(100 0(0)
0(0)
|
0(0)
0(0) 1(10
|
0(0)
0(0
(100
|
0(0)
1(00)
0(0)
|
1(100
0(0)
0(0)
|
0(0)
1(100 0(0)
|
0(0)
0(0
1(100
|
0(0)
0(0)
1(100
|
0(0)
0(0)
1(100
|
1(100
0(0) 0(0)
|
|
Total (n=5)
|
5
|
R
I
S
|
4(80)
0(0)
1(20)
|
2(40)
0(0)
3(60)
|
0(0)
0(0)
5(100
|
3(60)
1(20)
1(20)
|
4(80) 1(20 )
0(0)
|
5(100
0(0)
0(0)
|
4(80)
1(20)
0(0)
|
3(60)
0(0)
2(40)
|
4(80) 0(0) 1(20)
|
1(20) 3(60) 1(20)
|
2(40)
0(0)
3(60)
|
|
Abbreviations: R = Resistant, S = Sensitive, I = Intermediate, AMC= Amoxicillin-Clavulanate acid, CFM=Cefepime,CTR=Ceftriaxone,CHL=Chloramphenicol, CIP= Ciprofloxacin, CN=Gentamicin , MER=Meropenem, NIT=Nitrofurantoin, TET=Tetracycline, SXT=Trimethoprim-Sulfamethoxazole, DC=Doxycycline.
Table 8: Multidrug resistance patterns of bacteria isolated from renal allografts.
Bacterial isolates
|
Total (%)
|
Antibacterial patterns
|
R0
|
R1
|
R2
|
R3
|
R4
|
≥R5
|
Gram-negative
|
5(45.4)
|
0(0.0)
|
0(0.0)
|
0(0.0)
|
2(40)
|
1(20)
|
2(40)
|
E.coli
|
2(40)
|
0(0.0)
|
0(0.0)
|
0(0.0)
|
1(50)
|
0(0.0)
|
1(50)
|
Acinetobacter spp.
|
2(40)
|
0(0.0)
|
0(0.0)
|
0(0.0)
|
0(0.0)
|
1(50)
|
1(50)
|
P.mirabilis
|
1(20)
|
0(0.0)
|
0(0.0)
|
(0.0)
|
1(100)
|
0(0.0)
|
0(0.0)
|
Gram-positive
|
6(54.6)
|
0(0.0)
|
1(16.7)
|
1(16.7)
|
0(0.0)
|
3(50)
|
1(16.7)
|
S.aureus
|
2(33.33)
|
0(0.0)
|
0(0.0)
|
0(0.0)
|
0(0.0)
|
2(100)
|
0(0.0)
|
CoNS
|
2(33.33)
|
0(0.0)
|
1(50)
|
0(0.0)
|
0(0.0)
|
1(50)
|
0(0.0)
|
Enterococcus spp.
|
2(33.33)
|
0(0.0)
|
0(0.0)
|
1(50)
|
0(0.0)
|
0(0.0)
|
1(50)
|
Total
|
11(100)
|
0(0.0)
|
1(9.1)
|
1(9.1)
|
2(18.2)
|
4(36.4)
|
3(27.3)
|
R0-=No antibiotic resistance, R1= Resistance to one, R2=Resistance to two, R3=Resistance to three, R4-=Resistance to four, ≥ R5=resistance to five and more drugs.
Table 9: Multivariate risk factor analysis among post renal transplantation UTI.
Risk factor
|
Significant bacteriuria
|
AOR
|
95% CI
|
P-value
|
Age(years)
|
Yes no (%)
|
No no (%)
|
18-34(n=29)
|
4(13.8)
|
25(86.2)
|
1
|
1
|
|
35-49(n=31)
|
6(19.3)
|
25(80.6)
|
2.61
|
2.06–18.91
|
<0.001
|
50-64(n=10)
|
1(10)
|
9(90)
|
1.531
|
0.341-3.271
|
0.245
|
>64(n=4)
|
0(0.0)
|
4(100)
|
N/A
|
N/A
|
|
Pre-transplant UTI history
|
|
|
|
|
|
Yes(n=5)
|
2((40)
|
3(60)
|
3.48
|
2.12-9.39
|
0.02
|
No(n=69)
|
9(13)
|
60(87)
|
N/A
|
N/A
|
|
History of previous catheterization
|
|
|
|
|
|
Yes(n=5)
|
1(20)
|
4(80)
|
3.29
|
2.05–11.85
|
0.003
|
No(n=69)
|
10(14.5)
|
59(85.5)
|
1.84
|
0.27-15.38
|
0.195
|
AOR=Adjusted Odds Ratio, 95% CI =95% Confidence Interval & N/A= Not Applicable.