Bacterial profile and antimicrobial sensitivity in chronic kidney failure patient

Abstract

Chronic kidney failure (CKF) patients, particularly those undergoing hemodialysis, are at increased risk of bacterial infections and antimicrobial resistance due to immunosuppression, repeated vascular access, and prolonged antibiotic exposure. This study aimed to characterize the bacterial profiles and antibiotic sensitivity patterns among CKF patients, with a comparative focus on those receiving hemodialysis versus those not on dialysis. A prospective observational cohort study is conducted over six months at a nephrology unit. Fifty adult CKF patients are recruited and divided into two groups (25 hemodialysis and 25 non-dialysis). Clinical data are collected, and microbiological specimens (urine, blood, sputum, wound swabs) are cultured and analyzed. Bacterial identification followed standard
biochemical protocols, and antimicrobial susceptibility is determined using the Kirby-Bauer disk diffusion method in accordance with CLSI guidelines. Staphylococcus aureus is significantly more prevalent in hemodialysis patients (36%) compared to non-dialysis patients (8%) (p=0.0405). E. coli is the most common Gram-negative isolate in both groups. Inhibition zone diameters are significantly smaller among hemodialysis patients for multiple antibiotics, including amoxicillin (p=0.0001), ciprofloxacin (p=0.0286), cefotaxime (p=0.0041), oxacillin (p=0.0013), and ceftazidime (p=0.0069), indicating reduced susceptibility. Binary logistic regression showed no significant demographic or
clinical predictors of positive cultures. Multivariate regression revealed that Klebsiella pneumoniae had the highest inhibition zones, while S. aureus had the lowest, irrespective of patient group. Hemodialysis patients exhibit greater prevalence of S. aureus and reduced antibiotic susceptibility, suggesting the need for enhanced infection control and tailored empirical therapy. Species-specific patterns are critical in guiding antibiotic selection for CKF patients.