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Chronic Kidney Disease-An Underestimated Risk Factor for Antimicrobial Resistance in Patients with Urinary Tract
Ileana Adela Vacaroiu1,2, Elena Cuiban1,2, Bogdan Florin Geavlete3,4
1Department of Nephrology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Biomedicines
|October 27, 2022
Summary
Chronic kidney disease (CKD) significantly increases the risk of developing antibiotic-resistant bacteria (ARB) and multiple drug-resistant (MDR) urinary tract infections (UTIs). This study highlights CKD as a key risk factor for these challenging infections.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Chronic kidney disease (CKD) and antimicrobial resistance (AMR) are significant global health concerns.
- CKD is a known risk factor for complicated urinary tract infections (UTIs), but its role in AMR requires further evidence.
- Understanding risk factors for AMR and multidrug resistance (MDR) in UTIs is crucial for effective treatment strategies.
Purpose of the Study:
- To identify independent risk factors for antimicrobial resistance (AMR) and multidrug resistance (MDR) in adult patients with hospital-acquired urinary tract infections (UTIs).
- To determine the prevalence of antibiotic-resistant bacteria (ARBs) and MDR strains causing UTIs in the study population.
- To analyze the implicated resistance patterns associated with UTIs in patients with and without CKD.
Main Methods:
- An observational study was conducted on 564 adult patients diagnosed with UTIs during hospitalization.
- Data collected included patient demographics, medical history, and microbiological findings.
- Multivariate logistic regression analysis was used to identify independent risk factors for MDR UTIs.
Main Results:
- The most common uropathogen was Escherichia coli (68.3%), followed by Klebsiella spp. (11.2%).
- Antibiotic-resistant bacteria (ARBs) caused 54.4% of UTIs, and MDR strains were implicated in 30% of cases.
- Independent risk factors for MDR UTIs included indwelling urinary catheters (OR 5.388), CKD (OR 1.779), and chronic hemodialysis (OR 4.068).
Conclusions:
- Chronic kidney disease (CKD) is identified as a significant independent risk factor for both overall antimicrobial resistance and multiple drug resistance in UTIs.
- Indwelling urinary catheters and chronic hemodialysis also emerged as significant risk factors for MDR UTIs.
- These findings underscore the importance of managing CKD patients carefully to prevent and treat resistant UTIs effectively.
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