Urinary Tract Infections in the Early Posttransplant Period After Simultaneous Pancreas–Kidney Transplantation D. Kawecki, A. Kwiatkowski, G. Michalak, A. Sawicka-Grzelak, A. Mlynarczyk, B. Sokol-Leszczynska, I. Serafin, J. Czerwinski, W. Lisik, M. Bieniasz, M. Wszola, P. Domagala, W. Rowinski, M. Durlik, M. Luczak, A. Chmura, and G. Mlynarczyk ABSTRACT Objective. Urinary tract infection (UTI) is among the common infection in simultaneous pancreas-kidney transplantation (SPKT). Patients and Methods. The study included 26 adult patients undergoing SPKT between September 2001 and December 2006. All the patients were followed prospectively for UTI during the first 4 weeks after surgery. Urine samples were investigated for bacteriologic cultures. The micro-organisms were identified in accordance with standard bacteriologic procedures. Susceptibility testing was carried out using Clinical and Laboratory Standards Institute (CLSI) procedures. Results. Among 77 urine specimens obtained from all recipients during the first month, there were 30 isolated bacterial strains. The most common were Gram-positive bacteria (53.3%) with predominance of enterococci (75%) associated with high levels of amino- glycoside resistant strains (HLAR; 58.3%) and vancomycin-resistant strains (VRE; 25%). Gram-negative bacteria were detected in 46.7% of positive cultures. Conclusions. In our study, enterococci predominated as 75% of Gram-positive isolates. The increased proportion of multi-drug–resistant bacteria, which can caused severe UTI in patients after SPKT, may be due to the frequent use of prophylaxis of bacterial infections in patients. T HE TREATMENT of choice for a diabetic patients who has progressed to end-stage renal disease is a pancreas transplantation performed in conjunction with a kidney graft. 1 Pancreas recipients are at significant risk for infectious complications that can lead to significant morbid- ity and mortality. 2 Urinary tract infections (UTIs) in simul- taneous pancreas– kidney transplantation (SPKT) recipi- ents are a common cause of infectious complications in the early postoperative period. 3 According to the International Pancreas Transplant Registry (IPTR), 1183 SPKT were performed worldwide in 2003. 4 According to the Poltrans- plant database 20 SPKT are performed in Poland each year. 5 It has been reported in many studies that one of the major factors influencing morbidity and mortality among transplant patients are infections. 6–8 despite improved management. 9 The development of the solid organ trans- plantation procedure in Poland over the last decade re- quires a better understanding of the issue of infections in transplant recipients in our country. 10 UTI has been noted to occur in up to 80% of patients undergoing pancreas transplantation. 11 The aim of our study was to determine the etiologic agents associated with bacteruria and their susceptibility to From the Department of Medical Microbiology (D.K., A.S.-G., A.M., B.S.-L., I.S., M.L., G.M.), the Department of General Surgery and Transplantation (A.K., W.L., M.B., M.W., P.D., W.R., A.C.), the Department of Surgical Nursing and Transplantation (J.C.), the Department of Transplant Medicine and Nephrology (M.D.), Transplantation Institute, Medical University of Warsaw, and the Department of Emergency Medicine (G.M.), Bielanski Hospital Warsaw, Warsaw, Poland. Supported by a grant from Medical University of Warsaw (academic performance award Nr 13/APK/2008). Address reprint requests to Kawecki Dariusz, MD, PhD, Department of Medical Microbiology, Medical University of Warsaw, 5 Chalubinskiego Street, 02-004 Warsaw, Poland. E-mail: dkawecki@o2.pl 0041-1345/09/$–see front matter © 2009 by Elsevier Inc. All rights reserved. doi:10.1016/j.transproceed.2009.07.065 360 Park Avenue South, New York, NY 10010-1710 3148 Transplantation Proceedings, 41, 3148 –3150 (2009)