Abstract: TH-PO0944
Asymptomatic Bacteriuria in the First Month Post-Kidney Transplantation
Session Information
- Transplantation: Clinical - Glomerular Diseases, Infections, and Rejection
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Greig, Morgan, Georgetown University, Washington, District of Columbia, United States
- Amin, Ryeesa, Georgetown University School of Medicine, Washington, District of Columbia, United States
- Manning, Aria E, Georgetown University School of Medicine, Washington, District of Columbia, United States
- Mahmoudi, Parsa, Georgetown University School of Medicine, Washington, District of Columbia, United States
- Timpone, Joseph G., Georgetown University Medical Center, Washington, District of Columbia, United States
- Kumar, Rebecca N., Georgetown University Medical Center, Washington, District of Columbia, United States
Background
Asymptomatic bacteriuria (AB) affects approximately 30% of kidney transplant recipients within the first year of transplant. Although traditionally treated due to concern for development of urinary tract infections (UTIs), recent studies have demonstrated no significant difference in UTI incidence with or without treatment following the first month post-transplant. However, the benefit of treating AB within the first month remains unclear.
Methods
A retrospective cohort study using a convenience sample was conducted using electronic medical records of kidney transplant recipients ≥18 years old at MedStar Georgetown University Hospital between January 1, 2019, and December 31, 2021. Recipients of combined liver/kidney or pancreas/kidney transplant were excluded. Descriptive analyses assessed the development of UTI following AB in the first month post-transplant for patients who received treatment versus those who did not, and long-term implications associated with no treatment, including bacteremia, pyelonephritis, acute tubular necrosis (ATN), mortality, recurrent AB, hospitalization for UTI, allograft rejection (AGR), and C. difficile infection.
Results
Of the 294 kidney transplant recipients, 33 (11%) developed AB within the first month post-transplant. 9 of those patients had received antibiotic treatment, 1 (11.1%) of whom developed a UTI. The remaining 24 patients did not receive antibiotic treatment, 3 (12.5%) of whom developed a UTI. All UTI associated organisms differed from those associated with AB. Similar rates of AGR occurred in the group treated for AB (2/33; 6.1%) and in the group not treated for AB (15/261; 5.7%) (Table 1).
Conclusion
In summary, findings support cautious limitation of antibiotic use in early post-kidney transplant recipients. Further prospective, multicenter studies are needed to define optimal management of AB during the early post-transplant period.
Table 1
| Treated for AB | Not Treated for AB | No AB | |
| Total patients | 9 | 24 | 261 |
| UTI post AB | 1 | 3 | - |
| UTI w/ same organism as AB | 0 | 0 | - |
| Recurrent AB in 12 mo post KT | 2 | 10 | - |
| AGF in 12 mo post KT | 1 | 1 | 15 |
| C. diff infection in 12 mo post KT | 2 | 1 | 8 |
| Mortality in 12 mo post KT | 1 | 2 | 18 |