From the Guidelines

Ureteritis in renal transplant patients is a significant concern, but routine treatment of asymptomatic bacteriuria (ASB) is not recommended.

ASB is common in renal transplant patients, but treatment may not prevent pyelonephritis or graft rejection 1.
The use of prophylactic antimicrobial therapy, such as trimethoprim-sulfamethoxazole (TMP-SMX), is recommended for the prevention of Pneumocystis jirovecii pneumonia and may also decrease the frequency of symptomatic UTI and ASB 1.
However, the evolution of antimicrobial resistance to TMP-SMX may limit its efficacy in preventing UTI 1.
Routine treatment of ASB in kidney transplant recipients may increase colonization with resistant organisms without providing clear benefit and should be avoided after the first 2 months from transplantation 1.

UTI prophylaxis with daily trimethoprim-sulfamethoxazole is suggested for at least 6 months after transplantation 1.
For allograft pyelonephritis, initial hospitalization and treatment with intravenous antibiotics are recommended 1.
Urine cultures should be interpreted within their clinical context, including specific timing posttransplantation and symptoms 1.
Treatment of ASB should be avoided after the first 2 months from transplantation, unless the patient is symptomatic 1.

From the Research

Ureteritis is a rare complication in renal transplant recipients, with only six cases of symptomatic ureteritis reported in the literature prior to 2001 2.
Cytomegalovirus (CMV) ureteritis is an emerging complication of CMV disease, possibly due to changes in transplant practice, and can present as obstructive nephropathy or mimic allograft rejection 2.
Urinary tract infections (UTIs) are a common complication in kidney transplant patients, with up to 74% of patients experiencing at least one episode of UTIs in the first year after transplantation 3.
Risk factors for UTIs in renal transplant recipients include female gender, old age, diabetes mellitus, immunosuppression, pre-transplant UTIs, urinary tract abnormalities, and prolonged dialysis 3.
Cystic ureteritis is a rare pathology that can be associated with chronic infectious factors and can present with unspecific symptoms but characteristic radiologic findings 4.
UTIs in renal transplant recipients are most commonly caused by Escherichia coli and Enterococcus spp, and can be asymptomatic or symptomatic 5, 6.
Risk factors for UTIs in renal transplant recipients include female gender, history of acute rejection episode, and/or CMV infection, as well as vesicoureteral reflux or strictures at the ureterovesical junction 6.
UTIs do not appear to impair 1-year graft function in renal transplant recipients 6.