Research progress on the epidemiology and diagnostic technologies of urinary tract infections in kidney transplant recipients

In recent years, the increase in poor lifestyle and dietary habits (such as smoking, unhealthy eating) coupled with the high prevalence of chronic comorbidities including diabetes and hypertension has led to a rising number of patients with kidney disease. Kidney transplantation (KT), as an important means to improve the quality of life for patients with end-stage kidney disease (ESKD), has been widely applied in clinical treatment. However, post-kidney transplantation urinary tract infections (Post-KT UTIs), as a serious postoperative complication, severely threatens the safety of transplant recipients and the long-term function of grafts. Post-KT UTIs refer to an inflammatory reaction resulting from pathogen proliferation in the urinary system after transplantation, which may include cystitis, pyelonephritis, and in severe instances, can advance to bacteremia or sepsis, endangering both patient and graft survival. Post-KT UTIs are commonly caused by Gram-negative bacterial infections, notably by species such as Klebsiella pneumoniae and Escherichia coli (E. coli). Currently, the clinical detection and treatment of Post-KT UTIs remain based primarily on traditional urine culture and empirical antimicrobial therapy. This review introduces advanced detection methods such as next-generation sequencing and clustered regularly interspaced short palindromic repeats (CRISPR), aiming to offer new strategies for diagnosing Post-KT UTIs. Moreover, it reviews recent advancements in the epidemiology, treatment methods, and preventive strategies of Post-KT UTIs, and the role of gut and urinary microbiota in infection development, aiming to facilitate the development of novel therapeutic agents, vaccine formulations, and refined treatment strategies for precise management of Post-KT UTIs.