RESISTANCE IN THE SHADOWS: UROPATHOGENIC PROFILES IN CHRONIC KIDNEY DISEASE PATIENTS AND IMPLICATIONS FOR ANTIMICROBIAL STEWARDSHIP

Introduction: Urinary tract infection (UTI) is one of the few most frequently reported bacterial infections in general population only second to respiratory tract infections. It accounts for approximately 1 million hospitalizations annually. This study aims to determine the antibiogram of uropathogenic bacteria isolated from chronic kidney disease patients admitted in the department of nephrology and to determine the susceptibility of the isolated bacterial uropathogens to commonly used antibiotics. Material And Methods: It is a retrospective study, conducted at inpatient departments of medicine and nephrology at Goa Medical College. 50 patients with Chronic Kidney Disease (CKD) having Urinary tract infection (UTI) were included in the present study. Patients having UTI without CKD and patients having fungal UTI were excluded from study. Patients satisfying the inclusion criteria were randomly selected and their antibiogram was studied, with antibiotics grouped into Group A(Commonly used antibiotics) and Group B (Reserved antibiotics) drugs. Results: Of the total 50 CKD patients with UTI, majority presented with E.coli 14 (28%), followed by Klebsiella 10(20%), Pseudomonas aeruginosa 7(14%) and Staphylococcus species 7(14%) and Enterococcus 5(10%). The most effective antibiotics were those in group B for treating the infections. Conclusion: The pattern of antimicrobial resistance of bacteria producing UTI varies in different regions. A continuous review and monitoring of antimicrobial susceptibility can aid the clinician for prescribing the appropriate medication and prevent the development of drug resistance. Amikacin and Meropenem still show a good response compared to many of the bacterial spectrum in group A antibiotics in study. The Group B antibiotics show an over all better sensitivity to many of the organisms in present study