Characteristics of Asymptomatic Bacteriuria in Patients with Chronic Kidney Disease: A Tertiary Care Hospital Experience from a Developing Country.

ABSTRACT

Asymptomatic bacteriuria (ASB) is the isolation of bacteria in a urine sample from individuals who do not have any symptoms of a urinary tract infection (UTI). The outcomes of ASB in chronic kidney disease (CKD) patients are poorly understood in Pakistan. This study aimed to determine the characteristics of ASB and antibiotic susceptibility pattern among patients with CKD. A cross-sectional retrospective survey was administered to perform this study in a tertiary care hospital, to include all CKD patients. The study included all those patients with a diagnosis of CKD with no signs and symptoms of UTI present, and showing the growth of an organism in urine culture. A total of 175 urine cultures were observed retrospectively meeting the inclusion criteria through nonprobability consecutive sampling. Out of 175 urine cultures observed, mean age of 58.56 ± 16.81, 71% of them were females, 55% were diabetic, and 22% had a family history of CKD. Escherichia coli, Enterococcus, Klebsiella, Pseudomonas, Enterobacter, and streptococcal species were the most often isolated microbes. A total of 17 subjects got dual bacterial growth in their cultures which were having Enterococcus species as the most common organism. Twenty-three cultures were identified as pandrug resistant (13.14%), only sensitive to colomycin/polymyxin B. The susceptibilities of these organisms were contrasting to traditional antibiotics known to treat UTIs empirically, hence demanding further screening and treatment protocols to be defined for minimizing the irrational choice of antibiotics.