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Abstract: TH-PO1083

Antimicrobial Resistance and Unusual Organisms: A Double Whammy in CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Athavale, Bahaar Shirish, Bombay Hospital and Medical Research Centre, Mumbai, MH, India
  • Shah, Kriya Hardik, University of Nottingham, Nottingham, England, United Kingdom
  • Shah, Hardik Kirit, Bombay Hospital and Medical Research Centre, Mumbai, MH, India
Background

CKD patients have higher prevalence of Anti-Microbial Resistance (AMR) as compared to non-CKD patient population. The changing pattern of AMR and emergence of newer microorganisms has become a public health nightmare. This study compares the spectrum of AMR between CKD and non-CKD patients.

Methods

In this retrospective cohort study, positive bacterial/fungal isolates from various body specimens of out and inpatients from Jan 2022 till Dec 2024 at a tertiary healthcare facility were analyzed.

Results

Out of 4101 positive isolates ;CKD pts {Group A, n= 1680}had 1685 organisms (dialysis access -401 ,other fluids-1284); Non CKD pts {Group B,n=2421}had 2421organisms .Amongst dialysis access , prevalence of Klebsiella pneumoniae was highest at 27 %, E.coli -24 %,Pseudomonas aeruginosa -16 % ,Staphylococcus -15 % , Acinetobacter baumanii -8% and Enterococcus faecalis – 4 %. Unusual organisms such as Stenotrophomonas Maltophilia -17 pts ;Elizabethkingia meningoseptica -15; Burkholderia cepacia -11 and Candida parapsilosis -5 were isolated .AMR pattern was : cephalosporins – 95% ,Fluroquinolones -90 % ;Beta lactam –B lactamase inhibitors- 82 % ; carbapenems – 80 % aminoglycosides -65 % , colistin -40 %.Comparison of isolates from other fluids i.e.apart from dialysis access (viz.blood,urine,sputum,pleural fluid,ascitic fluid,CSF and tissue) between Group A and B revealed significantly higher AMR in CKD : cephalosporins – 85% vs 71 % (p=0.01),Fluroquinolones -78 % vs 60 %(p=0.03), ;Beta lactam –B lactamase inhibitors- 72 % vs 52 % (p=0.008), ; carbapenems – 66 % vs 46 %(p=0.01), aminoglycosides -55 % vs 39 % (p=0.03),, colistin -30 % vs 15 %.(p=0.04), Unusual organisms such as Serratia Marcescens, Trichosporon species, Morganella morganii, Ralstonia Mannitolilytica, Geotrichum species and Aeromonas hydrophilia were not isolated from Group B pts.

Conclusion

Resistance to higher antibiotics is prevalent more so amongst CKD patients. The onslaught of newer and unusual microorganisms is a double whammy that calls for stricter surveillance protocols, advanced diagnostics and search for effective antimicrobial agents.

Digital Object Identifier (DOI)