Burden of urinary tract infection on patient and hospital outcomes of renal transplant recipients

Background: Urinary tract infection (UTI) is a common hospital-acquired infection and is known to result in post-operative complications. Limited research, however, exists on the impact of such infection on patient and hospital outcomes among renal transplant recipients. In this study, we addressed such a gap in the literature by utilizing a national data.

Methods: We conducted a secondary analysis of the Nationwide Inpatient Sample 2009-2011 data. Design-based F values were utilized to conduct survey-weighted multivariable regression analyses to demonstrate the impact of secondary UTI on patient outcome (post-transplant complication) and health resource utilization (total charges and length of stay). Family-wise correction was employed to reduce type I error rate and significance was set at p < 0.003.

Results: A total of 1,044 renal transplant recipients, representing a population estimate of 49,862, were included in the study. Secondary UTI was most common upon renal transplant recipients with hypertension (53%), followed by diabetes (24%). We noted secondary UTI prevalence of 28.2 and 65.9 cases per 1,000 for men and women, respective. Such infection also increased the likelihood of post-transplant complications, such as transplant failure or rejection (182% men, 169% women). Total charges were 28% higher among men as compared to 22% among women upon secondary UTI. Similarly, secondary UTI increased the length of stay by 87% better to say how many extra days among men and 74% among women.

Discussion: We found a substantial negative impact of secondary UTI among renal transplant recipients. Few studies have evaluated short-term complications and health resource utilization among such patients. Our results show that Interventions to reduce UTI in renal transplant recipients are urgently needed, especially patients with diabetes and hypertension.