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Urinary tract infections (UTIs) are the most common bacterial infections; Given the characteristics of patients with chronic kidney disease in its different stages, it is possible that the appearance and diagnosis of such infection has its particularities, which are not routinely identified. The aim of the study is to identify the risk factors, etiology and resistance profile of urinary tract infections in patients with chronic kidney disease (CKD) stages 3 to 5 at Hospital during the 2022.
Descriptive, retrospective research carried out in the Department of Nephrology of North hospital from January to December 2022. A total of 104 patients over 18 years diagnosed by CKD stages 3 to 5 who had urinary tract infection corroborated by urine culture and antibiogram were enrrolled in the study after following inclusion and exclusion criteria.
A total of 104 patients with CKD with stages 3 to 5 (73.07% women and 26.9% men) were studied. The mean age was 49.5 ± 8.5 years. The etiology of the main kidney disease was secondary to diabetic kidney disease, followed by Nephroangiosclerosis, obstructive uropathy and unrelated etiology with a frequency (51%, 25%, 15% and 7% respectively). The patients were with CKD stage 3, 4 and 5 not HD and HD.
Bolivia is no exception to the great burden of resistance that affects many South American countries. Patients with CKD more frequently have risk factors for acquiring various infections; antibiotic treatment is also a particularly problematic issue, since it carries the risk of nephrotoxicity, the need for pharmacological adjustment to kidney function or dialysis and another very important aspect is the loss of residual function, there being patients who no longer have any volume of residual diuresis, which entails difficulty in taking samples for microbiological studies that often only have to be based on the patient's clinical symptoms. .
Finally, another important aspect to take into account is bacterial resistance in this population group, since many suffer from repeated infections and multiple episodes of antibiotic treatment, which leads to the development of bacterial resistance.
Optimization of alternative approaches to monitor local antibiotic resistance trends is recommended. Current data indicate high levels of resistance to trimethoprim-sulfamethoxazole and fluoroquinolones, and a considerable presence of ESBL strain determinants in Enterobacteriaceae, suggesting that nitrofurantoin and carbapenems could represent first-line treatment options for UTIs.