Comparative Evaluation of Urine Isolates in Kidney Transplanted and other UTI suspected Patients visiting National Public Health Labolatory, Teku

Abstract

This study was conducted in urine sample of patients visiting National Public Health Laboratory (NPHL), Teku, with an objective to assess the comparative evaluation of urine isolates in kidney transplanted and non-kidney transplanted patients visiting NPHL, Kathmandu, from April 2010 to January2011, a total of1233 clinical samples of urine were collected. Prevalence of uro pathogens was found to be 14.19% (175/1233).A total of 175 uro pathogens of which 16 different species were identified,out of which 12 species from Gram negative 94.29%(165/175)and 4 species from Gram positive 5.71% (10/175)were isolated. In Gram negative the most predominant was E.coli 61.14% (n=107), followed by Klebsiella pneumonia 12.57% (n=22), Klebsiella oxytoca 5.14% (n=9), Acine to bacter spp, and Pseudomonas aeruginosa 3.43% (n=6). From Gram positive, most prevalent were Enterococci spp 2.29% (n=4), Staphy lococcus a ureus, Staphylococcus saprophyticus and Streptococcusspp1.14% (n=2) were equally distributed.Out of total, 439 urine sample from Kidney transplanted patients,only5.01% (n=22)showed significant growth. The most efficient firstline antibiotics for isolates was found to be Ceftriaxone 68.57%, followedbyNitrofurantoin60%, and in second line antibiotics Ceftazidime–clavunic acid and Amikacin showed susceptibility of 89.55%. In the total 175 uropathogens,48% (84/175) isolates were found to be MDR positive. In gram negative Escherichiacoli 53.27%(57/107) showed highest percent of MDRand in Gram positive Enterococci spp 75 %(3/4) showed highest percent of MDR.For the different factors assessed for the UTI culture positive patients, in age group, 20-30years was found to have high positive patients.The infection rate was found to be higher in females57.71% (n=101) than in males42.29% (n=74). W where as male of age group 30-40 have higher 13.31%(n=24) positive cases. Association of significant bacteriuria and gender of patients was found to be statistically significant (P<0.05). There was strong association between Transplantation status and infection status(p<0.001). Key words: Urinary Tract Infection,Kidney transplant, MDR