Avaliação microbiológica das uroculturas de pacientes com doença renal crônica

Abstract

Introduction: Patients with chronic kidney disease (CKD) undergoing hemodialysis are predisposed to develop infections due to immunological, metabolic, and inflammatory alterations, mainly developing urinary tract infections. Objective: To evaluate epidemiological aspects of patients with CKD on hemodialysis as well as microbiological parameters of positive urine cultures. Materials and Methods: This is an observational, retrospective study analyzing the prevalence and antimicrobial sensitivity profile of uropathogens isolated from outpatients with CKD pre-dialysis and on dialysis at a teaching hospital in Minas Gerais, between January 2022 and December 2023. Results: Of the 828 urine cultures analyzed, 236 (28.5%) were positive for bacteria, 177 (75%) from female patients and 149 (63.1%) from patients over 60 years of age. Of the 247 isolates, 17 bacterial species were identified, with Escherichia coli (51.8%) being the most isolated. Among the 204 Enterobacterales isolates, 8 (3.9%) presented the ESBL phenotype, 4 (1.9%) the AmpC phenotype and 11 (5.3%) were resistant to carbapenems. Resistance to ciprofloxacin was 32.8% for E. coli and greater than 50% for most of the other Enterobacterales isolates. Conclusion: Bacterial resistance control measures should be implemented in order to prevent the selection and dissemination of resistant microorganisms in patients with CKD.