{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:57:19Z","timestamp":1784044639297,"version":"3.55.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,5,22]],"date-time":"2019-05-22T00:00:00Z","timestamp":1558483200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Fondo de Investigaciones Sanitarias","award":["FIS PI11 1540"],"award-info":[{"award-number":["FIS PI11 1540"]}]},{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["REIPI RD12\/0015"],"award-info":[{"award-number":["REIPI RD12\/0015"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["REIPI RD16\/0016"],"award-info":[{"award-number":["REIPI RD16\/0016"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Whether antibiotic treatment of asymptomatic bacteriuria (AB) can prevent acute graft pyelonephritis (AGP) in kidney transplant (KT) recipients has not been elucidated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this multicenter, open-label, nonblinded, prospective, noninferiority, randomized controlled trial, we compared antibiotic treatment with no treatment for AB in KT recipients in the first year after transplantation when urinary catheters had been removed. The primary endpoint was the occurrence of AGP. Secondary endpoints included bacteremic AGP, cystitis, susceptibility of urine isolates, graft rejection, graft function, graft loss, opportunistic infections, need for hospitalization, and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We enrolled 205 KT recipients between 2013 and 2015. AB occurred in 41 (42.3%) and 46 (50.5%) patients in the treatment and no treatment groups, respectively. There were no differences in the primary endpoint in the intention-to-treat population (12.2% [5 of 41] in the treatment group vs 8.7% [4 of 46] in the no treatment group; risk ratio, 1.40; 95% confidence interval, 0.40\u20134.87) or the per-protocol population (13.8% [4 of 29] in the treatment group vs 6.7% [3 of 45] in the no treatment group; risk ratio, 2.07, 95% confidence interval, 0.50\u20138.58). No differences were found in secondary endpoints, except for antibiotic susceptibility. Fosfomycin (P = .030), amoxicillin-clavulanic (P &amp;lt; .001) resistance, and extended-spectrum \u03b2-lactamase production (P = .044) were more common in KT recipients receiving antibiotic treatment for AB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Antibiotic treatment of AB was not useful to prevent AGP in KT recipients and may increase antibiotic resistance. However, our findings should be regarded with caution, due to the small sample size analyzed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofz243","type":"journal-article","created":{"date-parts":[[2019,5,22]],"date-time":"2019-05-22T07:30:09Z","timestamp":1558510209000},"source":"Crossref","is-referenced-by-count":42,"title":["Antibiotic Treatment Versus No Treatment for Asymptomatic Bacteriuria in Kidney Transplant Recipients: A Multicenter Randomized Trial"],"prefix":"10.1093","volume":"6","author":[{"given":"N\u00faria","family":"Sab\u00e9","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, Spanish Network for Research in Infectious Diseases (REIPI), and Clinical Sciences Department, Faculty of Medicine, University of Barcelona, L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Oriol","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, Spanish Network for Research in Infectious Diseases (REIPI), and Clinical Sciences Department, Faculty of Medicine, University of Barcelona, L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Melilli","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitari de Bellvitge-IDIBELL, and Clinical Sciences Department, Faculty of Medicine, L\u00b4Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Manonelles","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitari de Bellvitge-IDIBELL, and Clinical Sciences Department, Faculty of Medicine, L\u00b4Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriol","family":"Bestard","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitari de Bellvitge-IDIBELL, and Clinical Sciences Department, Faculty of Medicine, L\u00b4Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Polo","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitari de Bellvitge-IDIBELL, and Clinical Sciences Department, Faculty of Medicine, L\u00b4Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibai","family":"Los Arcos","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitari Vall d\u2019Hebron-VHIR, Spanish Network for Research in Infectious Diseases (REIPI), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manel","family":"Perell\u00f3","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitari Vall d\u2019Hebron-VHIR, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolors","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Hospital Universitari de Bellvitge-IDIBELL, L\u00b4Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Llu\u00eds","family":"Riera","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Teb\u00e9","sequence":"additional","affiliation":[{"name":"Statistical Assessment Service at Bellvitge Biomedical Research Institute (IDIBELL) and Department of Basic Sciences, Universitat Rovira i Virgili, L\u2019Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d2scar","family":"Len","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitari Vall d\u2019Hebron-VHIR, Spanish Network for Research in Infectious Diseases (REIPI), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Moreso","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitari Vall d\u2019Hebron-VHIR, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep M","family":"Cruzado","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitari de Bellvitge-IDIBELL, and Clinical Sciences Department, Faculty of Medicine, L\u00b4Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Carratal\u00e0","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, Spanish Network for Research in Infectious Diseases (REIPI), and Clinical Sciences Department, Faculty of Medicine, University of Barcelona, L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,5,21]]},"reference":[{"key":"2020081003572777600_CIT0001","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.transproceed.2009.11.029","article-title":"Risk factors for urinary tract infections during the first year after kidney transplantation","volume":"42","author":"Sorto","year":"2010","journal-title":"Transplant Proc"},{"key":"2020081003572777600_CIT0002","doi-asserted-by":"crossref","first-page":"S58","DOI":"10.1111\/j.1365-2362.2008.02014.x","article-title":"Urinary tract infection in renal transplant recipients","volume":"38","author":"S\u00e4emann","year":"2008","journal-title":"Eur J Clin Invest"},{"key":"2020081003572777600_CIT0003","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1086\/320905","article-title":"Management of urinary tract infections and lymphocele in renal transplant recipients","volume":"33","author":"Mu\u00f1oz","year":"2001","journal-title":"Clin Infect Dis"},{"key":"2020081003572777600_CIT0004","doi-asserted-by":"crossref","first-page":"2414","DOI":"10.1016\/j.transproceed.2006.08.018","article-title":"Epidemiology of urinary infections in renal transplant recipients","volume":"38","author":"Valera","year":"2006","journal-title":"Transplant Proc"},{"key":"2020081003572777600_CIT0005","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1093\/ndt\/gfq531","article-title":"Acute graft pyelonephritis in renal transplant recipients: incidence, risk factors and long-term outcome","volume":"26","author":"Fiorante","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"2020081003572777600_CIT0006","doi-asserted-by":"crossref","first-page":"2262","DOI":"10.1016\/j.transproceed.2009.06.079","article-title":"Early bacteremia after solid organ transplantation","volume":"41","author":"Linares","year":"2009","journal-title":"Transplant Proc"},{"key":"2020081003572777600_CIT0007","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1097\/TP.0b013e3181e8a680","article-title":"Bloodstream infection after kidney transplantation: epidemiology, microbiology, associated risk factors, and outcome","volume":"90","author":"Silva","year":"2010","journal-title":"Transplantation"},{"key":"2020081003572777600_CIT0008","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.1038\/ki.2010.423","article-title":"Infection and chronic allograft dysfunction","volume":"78","author":"Dupont","year":"2010","journal-title":"Kidney Int"},{"key":"2020081003572777600_CIT0009","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1111\/j.1600-6143.2006.01700.x","article-title":"Acute pyelonephritis represents a risk factor impairing long-term kidney graft function","volume":"7","author":"Pell\u00e9","year":"2007","journal-title":"Am J Transplant"},{"key":"2020081003572777600_CIT0010","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1399-3062.2006.00148.x","article-title":"Acute graft pyelonephritis following renal transplantation","volume":"8","author":"Kamath","year":"2006","journal-title":"Transpl Infect Dis"},{"key":"2020081003572777600_CIT0011","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1038\/ki.2010.219","article-title":"The impact of urinary tract infections in renal transplant recipients","volume":"78","author":"Lorenz","year":"2010","journal-title":"Kidney Int"},{"key":"2020081003572777600_CIT0012","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1111\/tid.12547","article-title":"Progressive increase of resistance in Enterobacteriaceae urinary isolates from kidney transplant recipients over the past decade: narrowing of the therapeutic options","volume":"18","author":"Orig\u00fcen","year":"2016","journal-title":"Transpl Infect Dis"},{"key":"2020081003572777600_CIT0013","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1111\/ajt.13075","article-title":"Impact of antibiotic resistance on the development of recurrent and relapsing symptomatic urinary tract infection in kidney recipients","volume":"15","author":"Bodro","year":"2015","journal-title":"Am J Transplant"},{"key":"2020081003572777600_CIT0014","article-title":"Urinary tract infections caused by ESBL-producing Enterobacteriaceae in renal transplant recipients: a systematic review and meta-analysis","volume":"19:e12759","author":"Alevizakos","year":"2017","journal-title":"Transpl Infect Dis"},{"key":"2020081003572777600_CIT0015","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.1111\/1469-0691.12687","article-title":"Multidrug-resistant bacteria in solid organ transplant recipients","volume":"20","author":"Cervera","year":"2014 ( 7)","journal-title":"Clin Microbiol Infect"},{"key":"2020081003572777600_CIT0016","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1093\/ndt\/gft432","article-title":"Should we treat asymptomatic bacteriuria after renal transplantation?","volume":"29","author":"Coussement","year":"2014","journal-title":"Nephrol Dial Transplant"},{"key":"2020081003572777600_CIT0017","first-page":"CD011357","article-title":"Antibiotics for asymptomatic bacteriuria in kidney transplant recipients","volume":"2","author":"Coussement","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"2020081003572777600_CIT0018","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1093\/ndt\/gfy078","article-title":"Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients: a survey of current practice in Europe","volume":"33","author":"Coussement","year":"2018","journal-title":"Nephrol Dial Transplant"},{"key":"2020081003572777600_CIT0019","first-page":"S1","article-title":"KDIGO clinical practice guideline for the care of kidney transplant recipients","volume":"9(Suppl 3)","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group","year":"2009","journal-title":"Am J Transplant"},{"key":"2020081003572777600_CIT0020","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1086\/427507","article-title":"Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults","volume":"40","author":"Nicolle","year":"2005","journal-title":"Clin Infect Dis"},{"key":"2020081003572777600_CIT0021","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.eimc.2015.03.020","article-title":"Executive summary. Management of urinary tract infection in solid organ transplant recipients: consensus statement of the Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI)","volume":"33","author":"Vidal","year":"2015","journal-title":"Enferm Infecc Microbiol Clin"},{"key":"2020081003572777600_CIT0022","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/ajt.12124","article-title":"Urinary tract infections in solid organ transplantation","volume":"13","author":"Parasuraman","year":"2013","journal-title":"Am J Transplant"},{"key":"2020081003572777600_CIT0023","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy1121","article-title":"Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America","author":"Nicolle","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2020081003572777600_CIT0024","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13507","article-title":"Urinary tract infections in solid organ transplant recipients: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice","author":"Goldman","year":"2019","journal-title":"Clin Tranplant"},{"key":"2020081003572777600_CIT0025","doi-asserted-by":"crossref","first-page":"2943","DOI":"10.1111\/ajt.13829","article-title":"Should asymptomatic bacteriuria be systematically treated in kidney transplant recipients? Results from a randomized controlled trial","volume":"16","author":"Orig\u00fcen","year":"2016","journal-title":"Am J Transplant"},{"key":"2020081003572777600_CIT0026","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1038\/ki.2010.286","article-title":"Systematic screening and treatment of asymptomatic bacteriuria in renal transplant recipients","volume":"78","author":"Fiorante","year":"2010","journal-title":"Kidney Int"},{"key":"2020081003572777600_CIT0027","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1111\/tid.12255","article-title":"Treated asymptomatic bacteriuria during first year after renal transplantation","volume":"16","author":"Go\u0142\u0119biewska","year":"2014","journal-title":"Transpl Infect Dis"},{"key":"2020081003572777600_CIT0028","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1097\/01.tp.0000226072.20185.f8","article-title":"Urine cytokines profile in renal transplant patients with asymptomatic bacteriuria","volume":"81","author":"Ciszek","year":"2006","journal-title":"Transplantation"},{"key":"2020081003572777600_CIT0029","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/j.1432-2277.2005.00007.x","article-title":"Strong inflammatory cytokine response in male and strong anti-inflammatory response in female kidney transplant recipients with urinary tract infection","volume":"18","author":"Sadeghi","year":"2005","journal-title":"Transpl Int"},{"key":"2020081003572777600_CIT0030","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.1016\/j.transproceed.2017.07.008","article-title":"Urinary tract infections in the first year post-kidney transplantation: potential benefits of treating asymptomatic bacteriuria","volume":"49","author":"Kotagiri","year":"2017","journal-title":"Transplant Proc"},{"key":"2020081003572777600_CIT0031","first-page":"32","article-title":"Effect of antibiotic therapy on asymptomatic bacteriuria in kidney transplant recipients","volume":"2","author":"Moradi","year":"2005","journal-title":"Urol J"},{"key":"2020081003572777600_CIT0032","doi-asserted-by":"crossref","first-page":"4109","DOI":"10.1093\/ndt\/gfr198","article-title":"Outcome of treated and untreated asymptomatic bacteriuria in renal transplant recipients","volume":"26","author":"El Amari","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"2020081003572777600_CIT0033","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s10096-012-1727-2","article-title":"Consequences of treated versus untreated asymptomatic bacteriuria in the first year following kidney transplantation: retrospective observational study","volume":"32","author":"Green","year":"2013","journal-title":"Eur J Clin Microbiol Infect Dis"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofz243\/28684927\/ofz243.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/6\/6\/ofz243\/33589685\/ofz243.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/6\/6\/ofz243\/33589685\/ofz243.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T08:07:48Z","timestamp":1597046868000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofz243\/5494787"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,21]]},"references-count":33,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofz243","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,6]]},"published":{"date-parts":[[2019,5,21]]},"article-number":"ofz243"}}