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

Julien Coussement 1 Umberto Maggiore 2 Oriol Manuel 3 Anne Scemla 4 Francisco López-Medrano Evi Nagler José María Aguado Daniel Abramowicz Brigitte Adams Caroline Agnelli Oana Ailioaie 5 Hamdi Akan Lucile Amrouche Amado Andrés Dany Anglicheau 6 Paul Arnouts Marije Baas Cristian Balgradean Bert Bammens Yuri Battaglia Thomas Baudoux Bert Berto Isabelle Binet Claus Bistrup Renzo Bonofiglio Jean-Louis Bosmans Yassine Bouatou Nicolas Bouvier 7 Philippe Braconnier Edwin Bredewold Nilufer Broeders Philippe Brunet 8 Matthias Buchler 9 Klemens Budde 10 Fanny Buron 11 Stéphane Burtey 12, 13 Andrea Buscaroli Stefan Büttner Catherine Byrne Rossana Caldara Elisabeth Cassuto 14 Concetta Catalano Guilhem Cavaille Alice Corbel 15 Lionel Couzi 16 Marta Crespo Sunil Daga Frederic Debellé 17 Ivana Dedinska Paul Devine Michael Dickenmann Max Dratwa Lubos Drgona Magdalena Durlik Maria Francesca Egidi Pedro Errasti Isabelle Etienne 18 María Carmen Fariñas Thomas Fehr Mario Fernández-Ruiz 19 Paraskevi Founta Konstantinos Fourtounas Eleni Frangou Luc Frimat 20 Luc Furian Maria Garjau Valérie Garrigue 21 Philippe Gatault 9 Colin Geddes Paul Gerlinger Eric Gheuens Lidia Ghisdal Paul Gibbs Magali Giral 22 Sophie Girerd 20 Dela Golshayan 3 Athina Gompou Paolo Antonio Grossi Gabriele Guglielmetti Luis Guirado Karine Hadaya Marc Hazzan 23 Mark Helbert Rachel Hellemans Katharina Heller Uwe Heemann 24 Manu Henckes Domingo Hernandez Alexandre Hertig 25 Christian Hiesse 26 Luuk Hilbrands Rachel Hilton Cédric Hirzel 27 Juan Pablo Horcajada Jean-Michel Hougardy Uyen Huynh-Do 28 Alma Idrizi Khalid Ismaili Carlos Jiménez 29 Noemie Jourde-Chiche 13 Nassim Kamar 30 Hannah Kaminski 31 Julia Kanter Alexandre Karras 32 Delphine Kemlin Petar Kes Mireille Kianda Maria Klinger Simon Knight 33 Irene Koneth Anita Krrashi Dirk Kuypers 34 Anne Langlois Philippe Lang 35 Ricardo Lauzurica Alain Le Moine David Lebeaux 36 Christophe Legendre 37 Anne Lemy Oscar Len Vassilios Liakopoulos Monika Lichodziejewska-Niemierko Maria Yague Kai Lopau Philippe Madhoun Maria Magott-Procelewska Shafi Malik Anna Manonelles Montero Marc Marchini Alessandra Marega Maria Mariat Mark Mark Pierre-Yves Martin 38 Leyre Martín Paloma Leticia Martín Annick Massart Marie Matignon 39 Stéphane Maurel Auxiliadora Mazuecos Christina Melexopoulou Edoardo Melilli Esperanza Merino Enisa Mesic Piergiorgio Messa 40 Magdalena Michalak Enrico Minetti Grigorios Miserlis Miguel Montejo Diego Moriconi Clément Mottola 41 Georges Mourad 42 Thomas Mueller 43 Patricia Muñoz 44 Alexander Nabokow Maarten Naesens 45 Maria Nikodimopoulou Rainer Oberbauer 46 María Olmedo Jonathon Olsburgh Gabriel Oniscu Lara Aygen Øzbay Alessandra Palmisano Aikaterini Papagianni Mario Papasotiriou Angelica Parodi Rob Parry Julio Pascual Isabel Pérez Flores María Pérez-Sáez Licia Peruzzi Camille Petit-Hoang 25 Paul Phelan Evangeline Pillebout 47 Giovanni Piotti 48 Lissa Pipeleers Christos Pleros Joyce Popoola Renzo Pretagostini Erasmia Psimenou Josep Puig 49 Cédric Rafat 25 Silvie Rajnochova Bloudickova Irena Rambabova Bushljetikj Marina Ratkovic Dolores Redondo Tomas Reischig Thomas Robert 25 Luis Ferrero Merita Rroji Przemyslaw Rutkowski Alicja Rydzewska-Rosolowska Núria Sabé Dil Sahali 50 Bernd Salzberger Rafael San-Juan Beatriz Sánchez Sobrino Silvio Sandrini Lídia Santos Roxana Sava Stefan Schaub Johan Schikowski 20 Betoul Schvartz Urban Sester Jose Tiago Silva Renaud Snanoudj 37 Danio Somenzi Søren Sørensen 51 Georgios Spanos Jürg Steiger 52 Barbara Suwelack Eleni Theodoropoulou Eric Thervet 37 Stefan Thorban Giuliana Tognarelli Yasmina Tournay Leïla Tricot 53 Patrizia Tulissi Henri Vacher-Coponat 54 Maricela Valerio W van der Meijden Henk van Hamersvelt Steven van Laecke 55 Alain Vandivinit Raymond Vanholder 56 Massimiliano Veroux Ondrej Viklicky 57 Emanuela Vigo Claudio Viscoli 58 W Watschinger W Weekers W Welberry Smith W Martin Nereida Zeneli Angelos Zervos Lada Zibar Julien Zuber 59 Bianca Zukunft
51 Section of Microbiology [Copenhagen]
Department of Biology [Copenhagen]
Abstract : 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.
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Submitted on : Monday, May 6, 2019 - 2:19:01 PM
Last modification on : Wednesday, April 27, 2022 - 3:47:53 AM

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Julien Coussement, Umberto Maggiore, Oriol Manuel, Anne Scemla, Francisco López-Medrano, et al.. Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients: a survey of current practice in Europe. Nephrology Dialysis Transplantation, Oxford University Press (OUP), 2018, 33 (9), pp.1661-1668. ⟨10.1093/ndt/gfy078⟩. ⟨hal-02121198⟩

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