Rob E. Carpenter
1,2* 
1 University of Texas at Tyler, 3900 University Boulevard, Tyler, Texas 75799, USA
2 Department of Research, Advanta Genetics, 10935 CR 159, Tyler, Texas 75703, USA
Abstract
Renal transplant recipients face a heightened risk of complicated urinary tract infections (cUTIs) due to immunosuppression, anatomical changes, and recurrent urinary abnormalities. Traditional diagnostic methods, including standard urine cultures, are often insufficient in identifying fastidious organisms and multidrug-resistant (MDR) pathogens that contribute to recurrent infections. Emerging technologies, such as next-generation sequencing (NGS), offer a novel, culture-independent approach that improves pathogen detection, especially in cases involving polymicrobial infections or rare microbes. This article explores the role of NGS in addressing diagnostic limitations for renal transplant patients with cUTIs, highlighting its capacity to identify both bacterial and viral pathogens and their resistance profiles. The clinical relevance of NGS in enhancing treatment precision and improving graft outcomes is discussed, emphasizing the potential for reduced nephrotoxic effects from broad-spectrum antibiotics. As the incidence of antimicrobial resistance rises, advanced diagnostic solutions like NGS offer a promising path for optimizing post-transplant care and safeguarding graft function.
Implication for health policy/practice/research/medical education:
Next-generation sequencing (NGS) offers diagnostic potential in managing complicated urinary tract infections (UTIs) in renal transplant recipients by enabling precise pathogen identification and resistance profiling. Integrating NGS into care protocols can improve graft preservation, reduce hospitalizations, and support antimicrobial stewardship. Policies should prioritize its adoption, while research explores cost-effectiveness and clinical outcomes. Medical education must emphasize NGS to prepare clinicians for advanced diagnostic approaches, fostering improved patient outcomes and innovative care solutions.
Please cite this paper as: Carpenter RE. Renal transplant recipients and complicated UTIs: a path toward next-generation care. J Renal Inj Prev. 2025; 14(2): e38423. doi: 10.34172/jrip.2025.38423.