Study on Bacteriology of Urinary Tract Infection of Renal Failure Patients Undergoing Haemodialysis in a Tertiary Care Hospital

Abstract

Background: Urinary tract infections  though common both inacute  and  chronic  renal failure patients undergoing  haemodialysis, are difficult to diagnose due  to  subclinical  presentation andare often associated  with complications

 Objectives: To determine the prevalence of urinary tract  infection  in  haemodialysis  patients with renal  failure,  to isolate and identify the bacterial isolates and  the                        antimicrobial  sensitivity  pattern.

 Materials and  Methods: Clean catch midstream  urine   samples from 157  haemodialysis  patients  in renal  failure were   subjected  for  culture  and   sensitivity.

 Results: Urine samples  from49 (31%)  patients  out of  157  had  significant  growth. Gram negative bacteria such as E.coli  19 (38%), Klebsiellaspp,,  18(36%), Pseudomonas 4(8%), Proteus 4(8%), Acinetbacter 2( 4%)  and  gram positive         organism - Enterococci  2( 4%)  were  isolated . Gram             negative bacteria  were  found  to be  sensitive  to  Amikacin, Nitrofurantoin and Cefaperazone – sulbactam . Enterococci were sensitive to  Ampicillin, Linezolid and                         Vancomycin.        Extended spectrum beta- lactamase       producing  E.coli 14(26%) and Klebsiella species 12(33%) were identified.

 Conclusion: In  renal  failure  patients   on haemodialysis, urinary  tract infection  was detected  significantly . E.coli  was  found  to  be predominant  organism followed by Klebsiella  species.Isolation of ESBL-producing Klebsiella species was found to be more common followed by E.coli, and are of great concern; therefore, continuous monitoring of uropathogens in haemodialysis  patients and  antibiotic  sensitivity  pattern is  essential to prevent treatment failure .

 Keywords: Urinary tract infection , Haemodialysis , Antibiotic sensitivity