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Asymptomatic Bacteriuria, their Related Risk Factors and Antibiotic Susceptibility Pattern of Isolates Among Hemodialysis Patients

J Nepal Health Res Counc. 2025 Oct 17;23(2):329-334. doi: 10.33314/jnhrc.v23i02.4752.

ABSTRACT

BACKGROUND: Asymptomatic bacteriuria in hemodialysis patients is a common problem due to their decreased immunity and renal function which often leads to development of urinary tract infection and other complications. However, there are no adequate guidelines that recommend the routine screening and management of such patients in most of the developing countries including Nepal resulting in antibiotic misuse. This study was done to find the magnitude of asymptomatic bacteriuria among hemodialysis patients along with their antibiotic susceptibility and related risk factors.

METHODS: A descriptive cross-sectional study was conducted on hemodialysis patients from July 2023 to January 2024. Midstream clean catch technique was used for urine collection. Urine specimens were processed for identification of uropathogens and their antibiotic susceptibility test by Kirby Bauer disk diffusion method following standard guidelines. Statistical analysis was done by Excel 2016 and SPSS 26, the point estimate was calculated at a 95% confidence interval.

RESULTS: The overall prevalence of asymptomatic bacteriuria was 27%. Escherichia coli (43.47%) was the most frequent isolate. Imipenem and Amikacin were the most sensitive antibiotics among Gram negative isolates while Ceftriaxone and Nitrofurantoin were the most resistant antibiotics. Pseudomonas aeruginosa was the major multidrug resistant pathogen. Hypertension and Diabetes Mellitus were commonly associated risk factors for asymptomatic bacteriuria in hemodialysis patients.

CONCLUSIONS: This study demonstrates high prevalence of asymptomatic bacteriuria among hemodialysis patients. Routine screening of asymptomatic bacteriuria aids in early detection and management of complications along with optimization of antibiotic use.

PMID:41319073 | DOI:10.33314/jnhrc.v23i02.4752

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