Background: Urinary tract infection is the most common complication after kidney transplantation. It can cause\nsevere sepsis and transplant loss. Emergence of drug resistance among gram-negative urinary pathogens is the\ncurrent challenge for urinary tract infection treatment after kidney transplantation.\nMethods: This study analyzes the antimicrobial susceptibility of gram-negative urinary pathogens after kidney\ntransplantation from 2009 to 2012 at the Transplant Outpatient Clinic of the University Hospital Essen, Germany.\nKidney transplant patients at the University Hospital Essen receive regular follow up examinations after transplantation.\nMidstream urines were examined for bacteriuria at each follow up visit.\nResults: From 2009 to 2012 15.741 urine samples were obtained from 859 patients. In 2985 (19%) samples bacterial\ngrowth was detected. The most frequently detected gram-negative bacteria were E.coli 1109 (37%), Klebsiella spp.\n242 (8%) and Pseudomonas aeruginosa 136 (4.5%). Klebsiella spp. showed a significant increase of resistance to\ntrimethoprim-sulfamethoxazole by 19% (p = 0.02), ciprofloxacin by 15% (p = 0.01) and ceftazidime by 17% (p = 0.004).\nE.coli and P. aeruginosa isolates presented no significant differences of antimicrobial susceptibility to the analyzed\nantibiotics.\nConclusions: Antimicrobial resistance of Klebsiella spp. increased significant to trimethoprim-sulfamethoxazole,\nciprofloxacin and ceftazidime from 2009 to 2012.
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