{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:37:44Z","timestamp":1784299064450,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,7,3]],"date-time":"2017-07-03T00:00:00Z","timestamp":1499040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In kidney transplant recipients, episodes of bacteriuria are often treated regardless of the presence of symptoms because of the lack of clear treatment guidelines suggesting otherwise. This practice may lead to the development of antimicrobial resistance. Our aim was to determine the incidence, determinants, and impact of antimicrobial resistance in kidney transplant recipients with gram\u2010negative bacteriuria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We conducted a single\u2010center, retrospective cohort study in patients who underwent kidney transplantation between January 2008 and June 2013. To identify risk factors for the development of resistance, we used a logistic regression model with generalized estimating equations to account for within\u2010subject correlation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 318 patients who underwent kidney transplantation during the study period, 147 patients developed 555 gram\u2010negative episodes of bacteriuria. Resistance to trimethoprim\u2010sulfamethoxazole and quinolones, and production of extended\u2010spectrum \u03b2\u2010lactamase (<jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>) occurred in 52%, 21%, and 5% of isolated microorganisms, respectively. An increased risk of resistance to quinolones and production of <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content> were associated with concomitant diabetes (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>]: 2.29, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 1.11\u20104.74), the first year post transplantation (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 2.88, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.36\u20106.09), and antibiotic treatment in the previous 6\u00a0months (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 3.36, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.66\u20106.81). This resistance profile was also associated with the presence of symptoms, a longer duration of antibiotic treatment, and a higher rate of hospitalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Antimicrobial resistance to quinolones and production of <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content> were commonly seen, and were shown to demonstrate an adverse impact on outcomes in kidney transplant recipients with gram\u2010negative bacteriuria. The decision on treatment for asymptomatic bacteriuria should be made with caution, given the potential for the selection of resistant strains.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12722","type":"journal-article","created":{"date-parts":[[2017,5,9]],"date-time":"2017-05-09T16:13:13Z","timestamp":1494346393000},"source":"Crossref","is-referenced-by-count":13,"title":["Epidemiology and outcome of antimicrobial resistance to gram\u2010negative pathogens in bacteriuric kidney transplant recipients"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5933-3796","authenticated-orcid":false,"given":"Catherine","family":"Delmas\u2010Frenette","sequence":"first","affiliation":[{"name":"Department of Medicine Centre Hospitalier de l'Universite de Montreal (CHUM)  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Dorais","sequence":"additional","affiliation":[{"name":"Statsciences  Notre\u2010Dame de l'Ile Perrot QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Tavares\u2010Brum","sequence":"additional","affiliation":[{"name":"Department of Medicine Centre Hospitalier de l'Universite de Montreal (CHUM)  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Frenette","sequence":"additional","affiliation":[{"name":"Department of Medicine McGill University Health Center (MUHC)  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medicine Centre Hospitalier de l'Universite de Montreal (CHUM)  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar","family":"Medani","sequence":"additional","affiliation":[{"name":"Department of Medicine Centre Hospitalier de l'Universite de Montreal (CHUM)  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Duclos","sequence":"additional","affiliation":[{"name":"Department of Surgery Centre Hospitalier de l'Universite de Montreal (CHUM)  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Rouleau","sequence":"additional","affiliation":[{"name":"Department of Medicine Centre Hospitalier de l'Universite de Montreal (CHUM)  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib","family":"Mawad","sequence":"additional","affiliation":[{"name":"Department of Medicine Centre Hospitalier de l'Universite de Montreal (CHUM)  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azemi","family":"Barama","sequence":"additional","affiliation":[{"name":"Department of Surgery Centre Hospitalier de l'Universite de Montreal (CHUM)  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heloise","family":"Cardinal","sequence":"additional","affiliation":[{"name":"Department of Medicine Centre Hospitalier de l'Universite de Montreal (CHUM)  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912023412303"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1996.307"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra064928"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12124"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2005.00327.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01700.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2004.04.040"},{"issue":"3","key":"e_1_2_6_9_1","first-page":"S1","article-title":"KDIGO clinical practice guideline for the care of kidney transplant recipients","volume":"9","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work 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