Abstract: SA-PO0693
From Resistance to Resilience: Autologous Bacterial Lysate as a Novel Adjunct in a Pediatric Kidney Transplant Recipient
Session Information
- Pediatric Nephrology: Transplantation, Hypertension, AKI, Genetics, and Developmental Diseases
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Authors
- Morales-Montes, Edgar Eduardo, Universidad Nacional Autonoma de Mexico, Mexico City, CDMX, Mexico
- Mones, Karen Urbina, Universidad Nacional Autonoma de Mexico, Mexico City, CDMX, Mexico
- Eslava Campos, Carlos Alberto, Universidad Nacional Autonoma de Mexico, Mexico City, CDMX, Mexico
- Valverde, Saul, Universidad Nacional Autonoma de Mexico, Mexico City, CDMX, Mexico
- Castañeda, Maria Cristina, Universidad Nacional Autonoma de Mexico, Mexico City, CDMX, Mexico
Introduction
Congenital anomalies of the kidney and urinary tract (CAKUT) require kidney transplantation in almost half of affected children. Up to 30% of recipients are generally affected by recurrent urinary tract infections (rUTI), a condition that increases the risk of graft loss. Treatment of rUTI is complicated by the multi-resistant bacteria (Escherichia coli, Klebsiella sp, among others), that cause the infection. Autologous bacterial lysates (ABL), prepared with microorganisms isolated from the patient, offer a novel immunomodulatory approach. We present a pediatric case of post-transplant rUTI, whose infections were successfully controlled with ABL.
Case Description
A 16-year-old male with end-stage renal disease received a kidney transplant in July 2023. Following transplantation, he developed febrile urinary tract infections or episodes of urosepsis associated with ESBL-producing E. coli and K. pneumoniae for 8 months. Despite treatment (anticholinergics, clean intermittent catheterization, and antimicrobials), the infections persisted even with IV ertapenem and amikacin. Graft function worsened over time (up to 4.5 mg/dL), requiring multiple hospitalizations.
In January 2025, the patient began oral autologous bacterial lysate (1 mL/day) derived from ESBL-positive E. coli, with good tolerance. Urosepsis did not occur after administration, and within four months, the patient only presented a mild urinary tract infection associated with multisensitive E. coli. Serum creatinine stabilized (2.5–3.2 mg/dl), and clinical improvement was observed.
Discussion
This case illustrates how autologous bacterial lysates influence the management of post-transplant rUTI, when conventional procedures fail. Animal studies with lysates have shown that they inhibit bacterial growth in the bladder and activate the immune response. However, our preliminary experience suggests that personalized immunotherapy could reduce the infectious burden, preserve graft function, and improve quality of life. Further studies are needed to define its role in pediatric post-transplant care.