Urinary Tract Infections In Solid Organ Transplant Recipients

Urine culture collection technique is important. After use of antiseptic wipes to clean the perineum/glans, a midstream urine sample is collected in a sterile container. In patients unable to perform these steps, straight catheterization to obtain a urine specimen can be considered. For patients with indwelling catheters (especially those in place >2 weeks) and a suspected UTI, the catheter should be removed and a specimen collected either via a midstream urine or newly placed urinary catheter. (Low, Strong)

Because asymptomatic bacteriuria (AB) is not necessarily a disease state, it should not be uniformly classified as a UTI. (Moderate, Strong)

Lack of pyuria should prompt consideration of an alternative diagnosis; yet, depending on the performance characteristics of the urinalysis or presence of neutropenia, even if < 10 WBC/mL in the urine, an otherwise consistent clinical context may still be indicative of UTI in a KT recipient. (Low, Strong)