[Urinary tract infections in children following renal transplantation: a single-center experience].

Background: Urinary tract infection (UTI) is the most common complication after kidney transplantation and represents a potential life-threatening risk for the immunocompromised child.

Aim: The aim of this report is to determinate incidence, risk factors, microbiologic features and evaluate the impact of this complication on graft outcome and patient mortality.

Methods: We performed a retrospective cohort study reviewing the medical records of 17 children from 38 who received a renal transplant in our center between January 1992 and june 2008 and who present an urinary tract infection.

Results: All patients received Lich-Gregoire implantation and insertion of double-J stunt. Antibioprophylaxis was not systematic. After a mean period of 6 years, 9 children (5+4) developed early UTI (during the first month after transplantation) and 5 (3+2) had late UTI. Three patients (2+1) with an indeterminate nephropathy developed early and late UTI. Causal agents are: E. Coli, Klebsiella Pneumoniae and Candida albicans. The further voiding cystourethrography showed a vesico-ureteral reflux on graft in 5 cases. Among the 17 patients, 4 lost their graft and are actually on haemodialysis.

Conclusion: The urinary tract infection represents the major complication after renal transplantation. Diagnosis ant treatment must be made early to avoid the loss of the graft.