International Journal of Microbiology Research and Reviews ISSN: 2329-9800 Vol. 3 (1), pp. 001-006, January, 2013. Available online at www.internationalscholarsjournals.org © International Scholars Journals Full Length Research Paper Urinary tract infections in Kidney transplant patients of Kathmandu Valley Upadhyaya G 1 , Bhattarai A 1 , Rijal KR 1 , Ghimire P 1 and Upadhyaya B 2 1 Central Department of Microbiology Tribhuvan University, Kirtipur, Kathmandu, Nepal. 2 National Public Health Laboratory, Teku, Kathmandu, Nepal. Accepted 04 December, 2013 A laboratory based study was carried out with the objective to isolate the bacteria causing UTI in kidney transplanted and other UTI suspected patients and find out their antibiotic susceptibility pattern. A total of 1233 urine samples (439 urine samples from kidney transplanted patients) were collected and subjected to laboratory analysis and culture. The prevalence of uropathogens was found to be 14.19% (175/1233). Out of total 175 isolates of uropathogens, 16 different bacterial species were identified, of which 94.29% (165/175) gram negative bacteria were belonging to 12 different species. In gram negative the most predominant was Escherichia coli (64.14%), followed by Klebsiella pneumoniae (12.57%), Klebsiella oxytoca (5.14%), Acinetobacter spp. and Pseudomonas aeruginosa (3.43%). Out of total, 439 urine samples from Kidney transplanted patients, only 22 samples (5.01%) had showed significant growth. The most efficient first line antibiotics for isolates was found to be Ceftriaxone 68.57%, followed by Nitrofurantoin 60% and in second line antibiotics Ceftazidime –clavunic acid and Amikacin showed susceptibility of 89.55%. Out of 175 uropathogens, 48% (84/175) isolates were found to be MDR positive. In gram negative bacteria, E. coli showed highest percentage of MDR that is 53.27%. Association of significant bacteriuria and gender of patients was found to be statistically significant (p<0.05). Transplantation status and infection status were found to have strong association (p<0.001). Key words: Uropathogens, Kidney transplanted patients, MDR, bacteriuria, antibiotics. INTRODUCTION The term Urinary tract infection (UTI) refers to the invasion of the urinary tract by a non resident infectious organisms. Kass (1956), gave a criterion of active bacterial infection of urinary tract according to which, a count exceeding 10 5 organisms per ml denotes significant bacteriuria and indicates active UTI. Contamination accounts for less than 10 4 organisms per ml and usually less than 10 3 per ml (Arora, 2004). UTI is one of the most important causes of morbidity in the general population and it is the second most common cause of hospital visits. Recurrent infections are common and can lead to irreversible damage of kidneys, resulting in renal hypertension and renal failure in severe cases. In the community, women are more prone to develop UTI. About 20% of women experience a single episode of UTI during their lifetime, and 3% of women have more than *Corresponding author. E-mail: rijalkomal@yahoo.com one episode of UTI per year. Pregnancy also makes them more susceptible to infections (Das et al., 2006). UTI are important complications of diabetes and renal diseases, renal transplantation and structural and neurological abnormalities that interfere with urine flow. In 40% to 60% of renal transplant recipient, the urinary tract is the source of bacteria and in these patients recurrence is about 40% (Forbes et al., 2002). Kidney transplantation originated in the United States in 1954. In developed countries, approximately 75% of the transplants performed use organs from cadaveric donors while the developing countries transplant about 85-100% of the kidneys from living donors (Enns and Aryal, 2011). UTI is the most common post transplantation infection. Nearly, 80% of renal transplant recipient suffer at least one episode of infection during the first year after transplantation and infection remains the leading cause of morbidity and mortality throughout the post transplant course (Charfeddine et al., 2002). It is estimated that about 2.7 million people are suffering from kidney disease in Nepal and about two thousands add up to this