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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 A.B. 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

1 Department Infections Diseases

2 Azienda Ospedaliero-Universitaria di Parma

3 CHUV - Centre Hospitalier Universitaire Vaudois [Lausanne]

4 Réseau CENTAURE

5 Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière]

6 Service Néphrologie et transplantation rénale Adultes [CHU Necker]

7 U775 (IFR95) - Bases moléculaires de la réponse aux xénobiotiques

8 IEMN - Institut d’Électronique, de Microélectronique et de Nanotechnologie - UMR 8520

9 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours

10 Department of Nephrology

11 Hôpital Edouard Herriot [CHU - HCL]

12 Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM]

13 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research

14 Service de néphrologie

15 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy

16 Service de Néphrologie-transplantation-dialyse [Bordeaux]

17 LIPM - Laboratoire des interactions plantes micro-organismes

18 CHU Rouen

19 Unit Infectious Diseases

20 Service de Néphrologie [CHRU Nancy]

21 Service de Pédiatrie spécialisée

22 U1064 Inserm - CRTI - Centre de Recherche en Transplantation et Immunologie

23 Université de Lille

24 Department of Pulmonary Medicine

25 Service d'Urgences néphrologiques et transplantation rénale [CHU Tenon]

26 Service de néphrologie (CHU de Dijon)

27 Swiss Transplantation Cohort Study

28 Department of Nephrology and Hypertension, and Department of Clinical Research

29 CIMAR - Centro de Investigación en Ciencias del Mar y Limnología

30 Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation

31 UB - Université de Bordeaux

32 HEGP - Hôpital Européen Georges Pompidou [APHP]

33 Department of Medicine, Division of Hematology-Oncology

34 Department of Nephrology and Renal Transplantation

35 UGA UFRM - Université Grenoble Alpes - UFR Médecine

36 IMAGINE - U1163 - Imagine - Institut des maladies génétiques

37 Service de néphrologie adultes [CHU Necker]

38 CRPG - Centre de Recherches Pétrographiques et Géochimiques

39 IMRB - Institut Mondor de Recherche Biomédicale

40 Division of Nephrology

41 UL - Université de Lorraine

42 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]

43 Department of Laboratory Medicine

44 Clinical Microbiology and Infectious Diseases Department

45 University Hospitals Leuven [Leuven]

46 Department of Internal Medicine III

47 Service de rhumatologie

48 Kidney and Pancreas Transplantation

49 Department d'enginyeria quimica agraria i tecnologia agroalimentaria

50 Néphrologie Transplantation

51 Section of Microbiology [Copenhagen]

Department of Biology [Copenhagen]

52 University Hospital Basel [Basel]

53 Service Néphrologie Transplantation Rénale

54 Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM]

55 Renal Division

56 Nephrology Section [Ghent]

57 Dept. of Nephrology

58 Division of Infectious Diseases

59 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)

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.

Document type :

Journal articles

Domain :

Life Sciences [q-bio]

Complete list of metadata

https://hal-amu.archives-ouvertes.fr/hal-02121198
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Submitted on : Monday, May 6, 2019 - 2:19:01 PM
Last modification on : Tuesday, December 6, 2022 - 5:36:44 PM