Urinary tract infection in the immunocompromised host - Lessons from kidney transplantation and the AIDS epidemic

The incidence of urinary tract infection (Un) in immunocompromised patients is similar to that seen in the general population, although the consequences of the infection may be far greater. Cytokines elaborated in the course of UTI can in time influence a wide variety of processes; reactivation of such herpes viruses as cytomegalovirus; modulate the course of renal allograft rejection; and influence the host's response to other immunologic challenges. The standard of care in these patients is to correct anatomical problems affecting the urinary tract, control sepsis with parenteral therapy, and eradicate infection with a 10- to 14-day course of a tissue-penetrating antimicrobial agent. in the renal transplant recipient, low-dose trimethoprim-sulfamethoxazole prophylaxis is particularly useful.