Investigation of infections agents in the renal transplant recipients at pretransplant and posttransplant period

Renal transplantations is the most important and successful treatment of renal failure. Infections are frequently observed especially in the first 6 months after transplantation. In this study, 45 patients who underwent renal transplantation from cadaver and live donor in Çukurova Üniversity Balcalı Hospital Organ Transplantation Center were examined. In the examination, 1 week before the operation and 1, 3, 6 months after; CMV and BKV DNA studied with real time PCR method in the blood. The factors that reproduce in the cultures of urine, blood, respiratory tract and wound samples were investigated. In addition, it is aimed to investigate the bacteria, virus and fungal agents detected in urine cytology. It was seen that there was no reproduction in all 19 patients who had urine culture before transplantation. After transplantation E. coli 7(31.81%), K. pneumoniae and C. nonalbicans 5(22.72%) and E. faecalis 4(18.18%) most often reproduced. Before the operation, blood culture was taken from 42 of the patients. No reproduction was observed in 40 (95.2%) of these, only 2 (4.8%) of bacteria were grown. One of the reproducing bacteria is Oligella ureolytica and the other one is KNS. After transplantation S. hominis 4(36.36%), S. epidermidis 3(27.27%), P. aeruginosa and A. baumannii 2(18.18%) were most common in blood culture. In the culture of samples taken from the respiratory tract of 9 patients, if necessary, 3 and 6 months after the transplant; A. baumannii 4 (44.44%), K. pneumoniae 3 (33.33%), A. fumigatus and C. albicans 1 (11.11%) were most common reproduced. In 10 (22.22%) patients, M. tuberculosis culture was performed and no positivity was obtained. It was observed that A. baumannii 3(30%), K. pneumoniae and S. epidermidis 2(20%), C. krusei 1(10%) were most common reproduced in ten patients who underwent wound culture after transplantation. After transplantation, 11 (28.94%) BK virus positivity was found in 38 patients and CMV virus positivity was found in 25 (60.98%) of 41 patients. Decoy cell positivity was found in 11 (35.49%) of 31 patients whose urine cytology was examined. When comparing the positivity and negativity of decoy cell seen in urine cytology with CMV and BKV DNA positivity and negativities studied with real time PCR method, it was found that urine cytology is an important method especially for investigating the early cytopathic effect of BK virus. Viral infections (BKV and especially CMV infection) and accompanying opportunistic infections, which appear between the 1st and 6th months when immunosuppressive therapy is applied intensively, have been found to pose a risk for both kidney loss and patient death. Key words: Kidney transplantation, Bacteria, Virus, Fungu