Urinary tract infections in Kidney transplant patients of Kathmandu Valley

Abstract

A laboratory based study was carried out with the objective to isolate the bacteria causing UTI in kidney
transplanted and other UTI suspected patients and find out their antibiotic susceptibility pattern. A total of
1233 urine samples (439 urine samples from kidney transplanted patients) were collected and subjected to
laboratory analysis and culture. The prevalence of uropathogens was found to be 14.19% (175/1233). Out of
total 175 isolates of uropathogens, 16 different bacterial species were identified, of which 94.29% (165/175)
gram negative bacteria were belonging to 12 different species. In gram negative the most predominant was
Escherichia coli (64.14%), followed by Klebsiella pneumoniae (12.57%), Klebsiella oxytoca (5.14%),
Acinetobacter spp. and Pseudomonas aeruginosa (3.43%). Out of total, 439 urine samples from Kidney
transplanted patients, only 22 samples (5.01%) had showed significant growth. The most efficient first line
antibiotics for isolates was found to be Ceftriaxone 68.57%, followed by Nitrofurantoin 60% and in second
line antibiotics Ceftazidime –clavunic acid and Amikacin showed susceptibility of 89.55%. Out of 175
uropathogens, 48% (84/175) isolates were found to be MDR positive. In gram negative bacteria, E. coli
showed highest percentage of MDR that is 53.27%. Association of significant bacteriuria and gender of
patients was found to be statistically significant (p<0.05). Transplantation status and infection status were
found to have strong association (p<0.001).