North American Academic Research , Volume 3, Issue 03; March, 2020; 3(03) 448-460
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TWASP, USA 448
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North American Academic Research
Journal homepage: http://twasp.info/journal/home
Research
Bacteriological profile and antibiotic sensitivity pattern of uropathogens
in hemodialysis patients attending tertiary care hospital, Kathmandu,
Nepal
Abdul Karim Miya
1
, Mehraj Ansari
1
, Anil Dev Pant
2
, Ganesh Rai
1
, Kul Raj Rai
1, 3, 4
,
Shiba Kumar Rai
1, 5
1
Shi-Gan International College of Science and Technology, Kathmandu, Nepal
2
National Kidney Center, Banasthali, Kathmandu
3
CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology,
Chinese Academy of Sciences (CAS), Beijing, China
4
University of Chinese Academy of Sciences, Beijing, China
5
Nepal Medical College, Kathmandu
*
Corresponding author: mrseeyon@gmail.com
Accepted: 20 March, 2020; Online: 23 March, 2020
DOI : https://doi.org/10.5281/zenodo.3725002
Abstract: Hemodialysis (HD) patients are more susceptible to urinary tract infection (UTI) and
UTIs are an important cause of morbidity and mortality in these patients. This study was
conducted to find out the prevalence of UTI and multidrug-resistant (MDR) patterns of isolates
among HD patients. A cross-sectional study was carried out from February 2018 to August 2018
at the National Kidney Center (NKC), Banasthali, Kathmandu. A total of 200 (108 male and 98
female) mid-stream urine samples were collected from patients with renal failure undergoing
hemodialysis. Of them, 26% of samples showed significant bacteriuria. 22.2% and 30.4% of
samples showed significant bacteriuria among males and females, respectively (p=0.19). Among
the age-group, bacteriuria was ranked top at the age group >70 years (35.3.8%) followed by 51-
70 years (34.1%) (p=0.046). Nine different bacteria were isolated. Among them, the most
predominant organism was Esch. coli (32.7%) followed by Staph. aureus (26.9%), Staph.
saprophyticus (13.5%) and others. For the Gram-negative isolates, Imipenem (96.8%) was found
to be the most effective drug followed by Amikacin (83.9%) and Cefepime (64.5%). For Gram-
positive isolates, Cefepime (76.1%) was found to be the most effective drug. The organisms
showed 71.4% resistance to Cotrimoxazole and 57.1% resistance to Amoxicillin, Azithromycin,
and Nitrofurantoin. The overall prevalence of MDR was found to be 57.7% in HD patients.
Amikacin and Imipenem were found to be the drug of choice to treat UTI in HD patients. This
study will be beneficial for making treatment policy and reducing the risk of UTI in HD patients.
Keywords: Hemodialysis, UTI, bacteriuria, multidrug-resistant, Nepal