Journal of AdvancedMedical and Dental Sciences Research

Aim: To investigate the microbial composition of urosepsis in patients with chronic kidney disease (CKD) and evaluate its therapeutic management. Material and Methods: Total 100 patients of chronic kidney disease suffering from urosepsis who were subjected to detail clinical and laboratory evaluations. The Inclusion Criteria was patients more than 18 year of age, male & female patients who gave valid informed written consent for the study and patients fulfilling the Kidney Disease Improving Global Outcome criteria for Chronic Kidney Disease (CKD). All the routine blood tests were performed and samples sent to pathology and biochemistry laboratories respectively. To detect bacteremia, samples were sent for blood and urine cultures to microbiology laboratory. Results: The findings of blood and urine cultures along with treatment given is enlisted in the tables below, On blood culture, most common pathogen isolated was E. coli i.e. 35%, 24% cultures were sterile, 10% had colonies of Proteus, 6% shown Pseudomonas, Klebsiella and Polymicrobial colonies each. CONS was isolated in 5% patients, while staphylococci and Streptococci growth was observed in 3% each, 1% patient’s blood culture shown growth of Enterobacter and Candida each. Out of total 100 patients urine culture maximum growth of 49% of E. coli was seen, 12% had growth of Proteus, while Klebsiella and Pseudomonas growth was observed in 10% and 7% patients respectively. 60 (60%) were treated with Cefo-Sulb, f/b 19 (19%) patient were treated with Meropenem, f/b 15 (15%) were treated with Cephalexin f/b 2 (2%) each were treated with Imipeneme, Pip-Taz, Cefo-sulb with fluconazole, and Cefo-Sulb with Voriconazole to treat urosepsis till discharge. Conclusion: The predominant bacterium responsible for urosepsis in the current investigation was Escherichia coli, accounting for 49% of cases. The most often administered empirical antibiotics were Cefoperazone-Sulbactam (60%) and Meropenem (19%). Among the patients, 37% showed sensitivity to Cefoperazone-Sulbactam and 28% showed sensitivity to Meropenem.