PREVALENCE AND ANTIMICROBIAL RESISTANCE OF UROPATHOGENS IN PATIENTS WITH UROSEPSIS SECONDARY TO UROLITHIASIS
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Keywords
Urolithiasis, obstructive uropathy, urosepsis, antimicrobial resistance.
Abstract
A Cross-Sectional Study was performed with the inclusion of 190 patients from Sheikh Zaid Hospital Lahore. Patients were informed about the research and their consent was taken. Demographic factors included name, age, gender, BMI, duration of stone and infective symptoms, and diagnosis. Sterile containers were used to collect freshly voided urine and sent to pathology department for urine culture and antimicrobial resistance pattern. Reports were assessed for isolated pathogens and their resistance against antibiotics was noted as per operational definition. All this information was taken on Performa and patients were managed as per departmental protocol.
Results: Total of 90 patients, 7.8% (n=7) were in the age group of 20-45 years and 92.2% (n=83) were in 46-70 years age group. Mean age was 54.48±7.401 years. Distribution of BMI was 27.52±5.043 kg/m2, duration of stone was 4.63±1.495 months and duration of symptoms was 5.40±1.668 days. 51.1% (n=46) were male patients and 48.9% (n=44) females. The frequency E. coli, Klebsiella spp., Enterococcus spp., and Gram-positive bacteria was 57.8%, 11.1%, 14.4%, and 16.7% respectively. Fluoroquinolones were sensitive 1.1%, Sulfonamides 2.2%, Penicillin 2.2%, Cephalosporin 57.8%, Aminoglycoside 17.8%, Carbapenems 3.3%, Vancomycin 12.2%, Tazobactam/piperacillin 2.2% and sensitivity of Fosfomycin trometamol was 1.1%. Distribution of antimicrobial sensitivity pattern of isolated pathogen was done (p=0.293).
Conclusion: The most prominent bacteria was E.coli. Antimicrobial resistance makes the selection of empiric antibiotic treatment challenging in patients with urosepsis secondary to urolithiasis. This study would help in the updating of Local population-specific antimicrobial guidelines and timely treatment of urolithiasis will be ensured. Condition specific antibiograms would be recommended.
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Dr Khuram Fayyaz
Registrar KidneyTransplant Surgery, Federal Post Graduate Medical Institute, Shaikh Zayed Medical Complex Lahore
Dr Umair Afzal
SR, Urology and Kidney Transplant, Shaikh Zayed Hospital Lahore
Dr Ali Shandar Durrani
SR, Urology, Shaikh Zayed Hospital Lahore
Dr Ghazanfar Rafeq
SR, Urology, Ihsan Mumtaz Teaching Hospital Johar Town Lahore
Dr Mujahid Hussain
Assistant Professor, Urology and Kidney Transplant, Sharif Medical and Dental College Lahore
Dr Farhan Ali
Registrar, Transplant Surgery, Shaikh Zayed Hospital Lahore
