{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:20:53Z","timestamp":1782976853121,"version":"3.54.5"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Microbiol Infect Dis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>This study is a post-hoc analysis of a previously published observational study. The aim is to characterize the epidemiology, etiology and antibiotic practices in KTRs admitted due to urosepsis (US) and urinary tract infection (UTI) to a tertiary transplantation center between the period 2014\u20132019.The two study groups consisted of 101 KTRs with a primary episode of US and 100 randomly selected KTRs hospitalized for UTI as a control group. A post-hoc analysis of clinical and microbiological data was performed, and a local microbiological map was created.The estimated yearly incidence of US in the study population was 21.1 (95% CI: 15.3\u201326.9) cases per 1000 KTRs per year. Urosepsis accounted for 85% of all sepsis cases. The most common causative pathogen in both groups was <jats:italic>Escherichia coli<\/jats:italic>. In 46% and 11% of US and UTI cases, initial empiric antibiotic therapy had to be escalated until day 3 due to lack of clinical response or proven bacterial resistance. This delay in appropriate antibiotic treatment in the US group was significantly associated with mortality (OR\u2009=\u200910.1 with <jats:italic>p<\/jats:italic>\u2009=\u20090.021), need for acute renal replacement therapy (OR\u2009=\u20094.73 with <jats:italic>p<\/jats:italic>\u2009=\u20090.012) and non-recovery from AKI (OR\u2009=\u20093.18 with <jats:italic>p<\/jats:italic>\u2009=\u20090.031). After discharge from hospital, almost 60% of all study subjects received a prophylactic antibiotic course for prevention of UTI recurrence, which did not translate into a lower frequency of readmission due to UTI in a multivariable analysis.US is a common insult that contributes to graft failure in KTRs. We recommend adjusting US and UTI treatments to center-specific microbiological maps in order to optimize treatment outcomes, reduce development of antibiotic resistance, and avoid unnecessary exposure to nephrotoxic antimicrobial drugs.<\/jats:p>","DOI":"10.1007\/s10096-025-05181-x","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T07:35:00Z","timestamp":1749454500000},"page":"2129-2138","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Antibiotic practices in kidney transplant recipients with urosepsis are associated with treatment outcomes \u2013 a post-hoc analysis of an observational study"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2548-3008","authenticated-orcid":false,"given":"Tomasz","family":"Kr\u00f3licki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobiasz","family":"Kudla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8285-8956","authenticated-orcid":false,"given":"Anna","family":"Kr\u00f3licka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9578-0836","authenticated-orcid":false,"given":"Klaudia","family":"Bardowska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2747-8851","authenticated-orcid":false,"given":"Krzysztof","family":"Letachowicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6060-0751","authenticated-orcid":false,"given":"Ryszard","family":"Gawda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6734-978X","authenticated-orcid":false,"given":"Tomasz","family":"Czarnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2632-2409","authenticated-orcid":false,"given":"Magdalena","family":"Krajewska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-9328","authenticated-orcid":false,"given":"Dorota","family":"Kami\u0144ska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"key":"5181_CR1","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1111\/j.1399-0012.2006.00519.x","volume":"20","author":"GJ Alangaden","year":"2006","unstructured":"Alangaden GJ, Thyagarajan R, Gruber SA, Morawski K, Garnick J, El-Amm JM et al (2006) Infectious complications after kidney transplantation: current epidemiology and associated risk factors. 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The bioethical committee waived the need for obtaining informed consent due to retrospective character of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Most of the study authors have a dual affiliation due to subsequent change of place of work during the study or shortly after its completion.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Affiliations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}