Asymptomatic bacteriuria in chronic haemodialysis patients

ABSTRACT

Symptomless bacteriuria could be considered as a dormant source of overt urinary tract infection [UTI] and possible bacteremia in maintenance haemodialysis [HD] population. The study was conducted to detemine the magnitude and pattern of asymptomatic bacteriuria among HD patients and show the effect of HD session on the bacterial counts. Forty-four patients with chronic renal failure on regular HD treatments [five hours twice weekly] for 5 to 57 months duration were included. Bacterial counts were performed twice for each patient before and after dialysis to determine the effect of HD on total viable bacteria [T.V.B.], Staphylococcus aureus, Streptococcus haemolyticus, E. coli, Proteus, Klebsiella and Pseudomonas areuginosa. It was found that thirty patients [72.7%] showed positive urine cultures, 18% of the patients showed. an increase of the bacterial counts in the post-dialysis urine samples and 24% showed decrease of the bactrial counts in the post-dialysis samples. The difference was not statistically significant [P > 0.05]. Urine volume and haemoglobin level were found to be significantly lower, while serum aspartate and alanine aminotransferase [AST and ALT] were significantly higher in bacteriuric group than those in nonbacteriuric group. Age, sex, clinical data and serum creatinine, urea, glucose, calcium, phosphorus and albumin did not significantly differ in the two comparison groups. The bacteria encountered in the asymptomatic bacteriuric HD patients were Staphylococcus aureus [86.8%], Streptococci spp. [52.7%], E. coli [37.2%], Klebsiella spp. [18.6%], Proteus [12.4%] and Pseudomonas spp. [12.4%]. There were no significant differences in bacterial counts of the various types of bacteria before and after dialysis. In vitro sensitivity to antibiotics showed that more than 80% of isolated strain; are sensitive to Norfloxacin