scholarly journals Pattern of UTI in Chronic Kidney Disease: Experience from A Tertiary Care Hospital, Bangladesh

2021 ◽  
Vol 20 (1) ◽  
pp. 41-45
Author(s):  
Marina Arjumand ◽  
Golam Mohammad Tayeb Ali ◽  
Pradip Kumar Dutta ◽  
Md Habib Hassan ◽  
Kazi Md Abrar Hasan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Urine Samples ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Gram Positive ◽  
College Hospital ◽  
Cross Sectional ◽  
Gram Negative

Background: Urinary Tract Infection (UTI) is common and higher in prevalence in patients with Chronic Kidney Disease (CKD). To find out the frequency and clinicobacteriological pattern of UTI in CKD patients. Materials and methods: A cross-sectional study was done on 1000 of CKD patients attending Nephrology Department of Chattogram Medical College Hospital (CMCH) a tertiary level hospital in Bangladesh during January to December, 2017. Cleancatch midstream urine samples were collected from study populations irrespective of symptoms. Macroscopic and microscopic examinations were done. Urine samples were then inoculated in Blood agar and Mac’Conkey agar and incubated aerobically at 37 °C for 18-24 hours. Microscopic observations and conventional biochemical tests were done to identify the isolated organisms. Significant growth of organisms in urine was defined as UTI. The isolated organisms were tested for antimicrobial susceptibility by using modified Kirby Bauer technique. Results: The prevalence of UTI was 61.8%. with significant asymptomatic UTI for 28%. Gram-negative organisms were most frequent 564 (93%) with predominant Escherichia coli 399 (64%) followed by Klebsiella 113(18%) and Pseudomonas 39(6%). Among Gram positive isolates, Staphylococcus (6%) was the dominant organism isolated. Regarding antibiotic susceptibility, Gram-negative microorganisms were found to be most sensitive to carbapenem and amikacin whereas Gram-positive microorganisms were most sensitive towards carbapenem, colistin and linezolid. Conclusion: In CKD patients, asymptomatic UTI was detected significantly. E.coli was found to be predominant organisms and resistant towards most of the studied common antibiotics. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 41-45

scholarly journals A study of secondary hyperparathyroidism in patients with chronic kidney disease in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 271
Author(s):  
Vishnu Shankar H. ◽  
Mahendra Kumar K. ◽  
Jagadeesan M. ◽  
Kannan R. ◽  
Chitrambalam P. ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Population ◽  
Chronic Morbidity ◽  
Spss Software

Background: Secondary hyperparathyroidism (SHPT) is one of the less recognized complications in patients with chronic kidney disease (CKD). The prevalence of SHPT in various stages of CKD was evaluated by measuring the levels of intact parathyroid hormone (iPTH).Methods: This cross-sectional study was carried out in 100 CKD patients. Serum creatinine, calcium, phosphorous and iPTH levels were measured and statistical analysis was carried out using the SPSS software (IBM, NY, USA).Results: Among the 100 participants, the mean age (SD) was 59.3 (7.8) years. In our study population, 52% were men and the rest were females. Hypertension (75%) was the most common chronic morbidity. Prevalence of hyperparathyroidism among chronic kidney disease patients was 22% (95% CI: 14.7-30.9%). The prevalence of secondary hyperparathyroidism among dialysis and non-dialysis patients were 30% and 14% respectively which was statistically significant.Conclusions: SHPT is an important complication which is often underdiagnosed. Secondary hyperparathyroidism starts to develop when eGFR falls below 60ml/min. PTH levels starts to rise as the disease progress. Hence it is important for the treating physicians to monitor the PTH levels early in the course of CKD to prevent and treat bone mineral disease.

scholarly journals HEMATOLOGICAL PROFILE IN PATIENTS OF CHRONIC KIDNEY DISEASE WITH ITS SEVERITY IN A TERTIARY CARE HOSPITAL, NORTH ODISHA

2020 ◽  
pp. 182-187
Author(s):  
BIBHU PRASAD BEHERA
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hematological Parameters ◽  
Tertiary Care ◽  
Microcytic Anemia ◽  
Treatment Modalities ◽  
Unknown Etiology ◽  
Care Hospital ◽  
College Hospital ◽  
Correct Treatment

Objective: Efforts can be made to normalize the hematological parameters and slow the progress of the disease so that the morbidity and mortality in these patients with chronic kidney disease could be effectively reduced. Methods: The observational study was carried out in the Department of General Medicine, Pandit Raghunath Murmu Medical College Hospital, Baripada, between May 2018 and January 2019. Two hundred seventy patients of chronic kidney disease (CKD) above 15 years of age, satisfying the inclusion and exclusion criteria, were included in the study. Results: In our study, 179 (66.30%) were male, and 91 (33.70%) were female with M:F of 1.97:1. The average age of the patients in the study was 55.72±12.77 years. About 42.59 % (115) of the patients were between 46 and 60 years of age. About 35.56% of CKD cases had determined etiology and, 64.44% of cases had unknown etiology. Hemoglobin, RBC, and packed cell volume were significantly lower in the patients with CKD compared to the controls (p=0.0001), and RDW was considerably higher in the patients with CKD compared to the controls (p=0.0001). Microcytic anemia was the most prevalent type of anemia. There was a hugely significant association between the prevalence of thrombocytopenia and the severity of CKD (p=0.006). Conclusion: This study concluded that patients with CKD show abnormal hematological parameters. Evaluation of hematological parameters in these patients helps in classifying the type of anemia, aids in choosing the correct treatment modalities, and decreases mortality.

scholarly journals PREVALENCE OF DEPRESSION AND ITS ASSOCIATED FACTORS AMONG PATIENTS OF CHRONIC KIDNEY DISEASE IN A TERTIARY CARE HOSPITAL FROM ASSAM: A CROSS-SECTIONAL STUDY.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Hamad Jeelani ◽  
Manzoor A. Parry ◽  
Shruti Dange
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Prevalence Of Depression

Background: Chronic kidney disease (CKD) patients are at high risk of depressive disorders because of considerable psychological stress due to physical and social changes brought on by disease. The aim of this study is to assess the prevalence of depression in patients with CKD and the factors affecting it at a public tertiary care hospital. Methods: This cross-sectional study was carried out at the renal clinic of a tertiary care hospital. Data on 629 patients diagnosed with CKD from September 2014 to April 2016 was obtained. Nine-item Patient Health Questionnaire from PRIME-MD was used to assess the depression. Results: Of all the patients, 44.7% had depression. Mild depression was found to affect 28.9% of the patients followed by moderate depression and severe depression (15.4% and 0.4%, respectively). According to multiple logistic regression, the occurrence of depression was significantly higher with age below 60 years [odds ratio (OR) 1.5, 0.9–2.7; P<0.05], male gender (OR 1.4, 1.0–3.1; P<0.05), no treatment funding (OR 2.7, 1.3–4.6; P<0.05), education less than grade 12 (OR 1.3, 1.3–3.2; P<0.05), monthly income ≤INR 20,000 (OR 1.6, 1.1–3.6; P<0.05), CKD stage V (OR 1.4 1.0– 2.9; P <0.05), Patients on hemodialysis (HD) (OR 2.5, 1.2–4.5; P<0.05), comorbidities ≥3 (OR 1.6, 1.3–3.0; P<0.05), overweight (OR 2.4, 1.3–2.9; P<0.05), and duration of CKD >2 (OR 2.4, 1.4–4.4; P<0.05). Conclusion: About 44.7% of the patients were found to have depression. Patients’ age, gender, body mass index, treatment funding, education status, income, CKD duration and stage, HD status, and comorbidities were found to be significant factors affecting depression.

scholarly journals Prescribing pattern of drugs in chronic kidney disease patients on hemodialysis at a tertiary care hospital

2017 ◽  
Vol 6 (4) ◽  
pp. 928
Author(s):  
Narayana Murthy B. V. ◽  
Satyanarayana V.
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Hypoglycemic Agents ◽  
Phosphate Binders ◽  
Care Hospital ◽  
Oral Hypoglycemic Agents ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Mortality And Morbidity

Background: CKD (chronic kidney disease) is a general term for heterogeneous disorders affecting kidney structure and its function. It is defined as either kidney damage or a decreased glomerular filtration rate of less than 60 mL/min/1.73m2 for 3 or more months. Objective of present work is to study the drug utilization pattern in chronic kidney disease patients undergoing hemodialysis.Methods: After taking the clearance and approval from the institutional ethics committee, a cross sectional prospective observational study conducted on chronic kidney disease (CKD) patients undergoing hemodialysis, in the department of nephrology, of Rajarajeshwari Medical College and Hospital, Bangalore. The data was analyzed descriptively.Results: Study included 52 patients, among them 41 males, 11were females, with a mean age of 47.6yrs. In our study large number pt were suffering from hypertension (HTN) 88.46% (46), in them the calcium channel blocker (CCB) 08.48% (38) was most commonly prescribed anti hypertensive drug. Around 1/3 of pt suffering from diabetes mellitus (DM) 36.53% (19) most of these patients were treated with them treated with oral hypoglycemic agents (OHA), and less than half of pt treated with insulin01.56% (07). Other drugs like phosphate binders (calcium carbonate & acetate) used in 11.16% (50), aspirin in 08.70% (39), statins in 10.04% (45) pt were being most commonly prescribed drugs.  Totally 448 drugs were prescribed In 52 pts Ie about 8.61 drugs / prescription, showing poly pharmacy.Conclusions: Patients undergoing hemodialysis with CKD will be having multiple diseases associated, regular monitoring and counseling regarding these diseases and its complication may reduce the incidence of CKD and the mortality and morbidity associated. The poly pharmacy noted in the study found inevitable because of the multifactorial etiologiesinvolved and needful multi-interventional approach towards it.

scholarly journals Incidence and Risk Factors of Acute Kidney Injury in Acute Stroke - in a Tertiary Care Hospital

2019 ◽  
Vol 8 (1) ◽  
pp. 12-18
Author(s):  
Nitai Chandra Ray ◽  
Md Ayub Ali Chowdhury ◽  
Md Abdul Muqeet ◽  
Mahmud Javed Hasan ◽  
Ashutosh Saha Roy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Acute Stroke ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Care Hospital ◽  
Stroke Patients ◽  
College Hospital ◽  
Cross Sectional

Acute kidney injury (AKI) is a common complication after acute stroke. Multiple additional risk factors are also responsible for development of AKI during acute stroke. This cross sectional observational study was conducted with a total of 240 newly detected computed tomography (CT) confirmed acute stroke patients in Mymensingh Medical College Hospital with an aim to find out the incidence and risk factors of AKI in acute stroke. In this study, AKI developed in 15.42% of all types of acute stroke and more commonly in haemorrhagic stroke than in ischaemic stroke (23.44% vs. 12.50%, P<0.05). AKI was found more frequently (54.05%) in old >60 years age group and in male patients(17.93% vs. 11.58% & P>0.05). Again, AKI developed most commonly in chronic kidney disease (CKD) (33.33%, P<0.05) and then in diabetes mellitus (DM) (31.03%, P<0.05), in ischaemic heart disease (IHD) (28.11%, P<0.05), in hypertension (21.14%, P<0.05), in previous stroke (15.22%, P>0.05), in dyslipidaemia (13.33%, P>0.05), and in smoker (9.89%, P>0.05). Family history of (H/O) DM was present in 30.00% (P>0.05) and that of hypertension and kidney disease was present in 24.44% (P>0.05) and 25.00% (P>0.05) of stroke patients, respectively. Among the AKI patients, majority (70.27%) had hypertension and 37.84% had CKD, 29.73% had IHD. DM and smoker were 24.32%of each. Family H/O of hypertension, DM and kidney disease was present in 29.73%, 16.22% & 13.51 % of AKI patients, respectively. So, this study had identified several important risk factors of AKI, in particular age, sex, smoking, hypertension, DM, IHD, CKD and types of stroke. So, the risk score could be easily calculated to predict the risk of AKI in stroke patients. And thus to prevent the development of AKI is of utmost importance to reduce the related morbidity and mortality of acute stroke patients. A multicenter nationwide intensive research is needed to identify the precise mechanism, risk factors, their relation and actual outcome of AKI that develop in patients with acute stroke. CBMJ 2019 January: vol. 08 no. 01 P: 12-18

scholarly journals Microbiological Profile and Antibiotic Sensitivity Pattern of Bacteria in Diabetic Foot Ulcers in a Tertiary Care Hospital

2021 ◽  
Vol 08 (01) ◽  
pp. 1-8
Author(s):  
Gajender Singh Ranga ◽  
Keyword(s):  
Diabetic Foot ◽  
Tertiary Care ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
E Coli ◽  
Gram Positive Bacteria ◽  
Sensitivity Pattern

Introduction: Diabetic foot is any foot pathology due to diabetes or sequelae of diabetes mellitus. This study was conducted to identify the common microorganisms isolated from diabetic foot and to analyse the antibiotic susceptibility pattern of bacteria isolated from diabetic foot. Materials and Method: The study was a hospital based cross-sectional study where 146 foot ulcer samples (who had type 2 diabetes) were analysed. Swabs were collected from the edge and margins of ulcers, and organisms were identified by gram staining culture and biochemical reactions. Result:Out of 146 patients, 69 specimens showed growth of organisms. Total 84 aerobic organisms were isolated and out of them, 64 cases showed bacterial growth, in which 84 bacteria were isolated, which represented an average of 1.28 organisms per case. Among these organisms, 62 gram-negative and 22 gram-positive organisms were isolated. E. coli was the most common gram-negative isolate (23.81%), followed by Pseudomonas aeruginosa (21.4%), and Klebsiella pneumonia(8.33%), while among gram-positive bacteria, S. aureus was the most common isolate (22.6%). Conclusion: Incidence of growth was 47.2% in which E. coli (23.8%) was the most common isolate. Gram-negative bacteria were more common than gram-positive bacteria. Diabetic foot infections are polymicrobial in nature.

scholarly journals Bacterial etiology and antibiotic resistance pattern of neonatal sepsis: a study in a tertiary care hospital, in Bangladesh

2019 ◽  
Vol 6 (5) ◽  
pp. 1839
Author(s):  
Mahfuza Shirin ◽  
M. Monir Hossain ◽  
Manifa Afrin ◽  
Mohammad Abdullah Al Mamun
Keyword(s):  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Gram Positive Bacteria

Background: Neonatal sepsis is a leading cause of neonatal mortality and morbidity. The objective of the study was to detect causative microorganisms of neonatal sepsis and their antimicrobial resistance patterns.Methods: This prospective cross-sectional study was conducted from July 2017 to June 2018 in the Department of Neonatal Medicine and NICU of Dhaka Shishu (Children) Hospital (DSH). Neonates diagnosed with probable sepsis were studied. After enrollment, 1 mL blood was taken and sent to Microbiology department of DSH for culture and sensitivity. With baseline characteristics, clinical examination findings and outcome, were also recorded.Results: Rate of isolation of single organism was 9.2% (84/913). Out of 84 isolates, gram negative bacteria were 77.4% with Klebsiella pneumonae being the commonest (35, 41.7%), gram positive bacteria were 11.9% with Staphylococcus aureus and Streptococcus were equal (5, 5.95% each) and the remaining (9, 10.7%) isolated organism was Candida. Most of the isolated gram-negative bacteria were resistant to ampicillin, gentamicin, and ceftazidime; but gram-positive bacteria preserved 20-80% sensitivity. Klebsiella was more resistant than Acinetobacter to amikacin, netilmicin, ciprofloxacin and levofloxacin. Around 45-65% of gram-negative bacteria were resistant to imipenem and meropenem but gram-positive bacteria showed lesser resistance. Among the gram-negative bacteria, Klebsiella and Acinetobacter were resistant to piperacillin as same as carbapenem group, but gram-positive bacteria were 100% sensitive to piperacillin. All the gram-negative bacteria showed more resistance to 4th generation cephalosporin, cefepime than carbapenem. Out of culture positive 84 neonates, 63 (75.0%) were cured but 21 (25.0%) died. Among the 21 expired neonates, 47.6% (10/21) were infected with Klebsiella.Conclusion: This study observed that gram-negative bacteria causing neonatal sepsis predominantly, with emergence of Candida. All the isolated gram-positive and gram-negative organisms were mostly resistant to available antibiotics

scholarly journals Procalcitonin levels versus Microbiological profile in Central line associated bloodstream infections (CLABSI) of patients on Hemodialysis

2021 ◽  
Vol 12 (1) ◽  
pp. 34-41
Author(s):  
Madhura NS ◽  
Shashikala N ◽  
Mythri Shankar ◽  
Kowsalya R ◽  
Mythri KM
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
P Value ◽  
Specific Marker ◽  
Gram Negative Bacteria ◽  
Retrospective Case ◽  
Gram Positive ◽  
Gram Negative ◽  
Microbiological Profile

Background: CLABSI is one of the most common forms of hospital acquired systemic infection(sepsis), associated with high mortality. Although Procalcitonin (PCT) is proved be the earliest and specific marker for the diagnosis of sepsis, there is relatively sparse literature on the usage of this marker in CLABSI with chronic kidney disease (CKD). Aims and Objective: To correlate the Procalcitonin levels with microbiological profile of CLABSI CKD patients. Materials and Methods: A retrospective case control study was conducted in a tertiary care Nephro-Urology hospital in Bangalore, from January 2019 to December 2019 including all CKD patients (age>20 years) with central venous catheter undergoing Hemodialysis. Based on blood culture reports of these patients, they were divided into CLABSI (positive growth), and no growth. Procalcitonin was analyzed in both the groups. Statistical analysis was done using SPSS software version 17. Results: Sixty-one percentage of the CKD patients of mean age 46 years had CLABSI. Most common isolate in CLABSI CKD was Staphylococcus aureus (35%), followed by Escherichia coli (19%), Klebsiella pneumoniae (10%). Mean PCT was significantly higher (p value 0.001) in CP-CKD (Culture positive-chronic kidney disease) patients (36. 1±35.ng/ml) compared to CN-CKD (Culture negative-chronic kidney disease) (4.6±10.0.ng/ml). Also mean PCT for Gram positive (GP) isolates (28.7±30.2) was significantly lower (P value 0.0008) than that for gram negative (GN) isolates (53.6±33.7). Conclusion: The study highlights higher incidence of CLABSI in CKD patients. Higher PCT values were observed in gram negative bacteria compared to gram positive, indicating its probable role for differentiating CLABSI due to gram-positive and gram-negative bacteria.

scholarly journals BACTERIOLOGICAL PROFILE AND ANTIBIOTIC SENSITIVITY PATTERN OF HOSPITALACQUIRED SEPTICEMIA IN A TERTIARY CARE HOSPITAL IN NORTH EAST INDIA

2017 ◽  
Vol 10 (11) ◽  
pp. 186
Author(s):  
Aroop Mohanty ◽  
Shantikumar Singh T ◽  
Ankita Kabi ◽  
Pratima Gupta ◽  
Priyanka Gupta ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
North East ◽  
Sensitivity Pattern

Objective: The objective of this study was to determine the bacterial agents responsible for hospital acquired septicaemia and to determine the antibiotic sensitivity profile of the bacterial isolates.Methods:  Three hundred fifty hospitalized clinically suspect septicaemia cases were included in this cross sectional observational study during a period of one year. Blood samples were collected with aseptic precautions for culture following universal precautions. Anti-microbial susceptibility test of the bacterial isolates was performed according to Clinical and Laboratory Standards Institute (CLSI, USA) guidelines.    Results: Over two-thirds of cultures showed gram positive organism. The most frequently identified Gram positive bacteria were coagulase negative staphylococci and Staphylococcus aureus. Among gram negative bacteria Escherichia coli, Klebsiella spp and Salmonella typhi were isolated. In our study, coagulase negative staphylococci showed maximum resistance to penicillin and erythromycin. Enterobactereciae had maximum sensitivity to carbapenems, tigecycline and aminoglycosides.Conclusion: Gram positive pathogens predominated in the blood stream infections. Résistance to fluoroquinolones, especially in Gram negative bacteria was significantly high. Therefore, rapid microbiological diagnosis and the determinants of antimicrobial susceptibility become relevant for early initiation of antimicrobial therapy.     

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