Prevalence of urinary tract infection among chronic renal failure in Khartoum state

Abstract

Introduction: Urinary tract infection (UTI) is one of the most common infections and it account for about 1 – 2% of all consultation. It has been estimated that more than six million out-patient visits and 300,000 hospital stays every year are due to UTIs. Approximately 10% of humans will have a UTI at some time during their lives. Despite an increasing population of patients with chronic renal insufficiency, the literature on the management of urinary tract infections (UTI) in these patients is sparse.

Objective: This study was conducted to detect the frequency of UTIs in chronic renal failure patients, isolate and identify the bacterial causative agents, determine the effective treatment and to study the validity of pyuria as indication to UTIs.

Methods: Descriptive cross–sectional study was conducted at Khartoum state dialysis centers. The period of the study enrollment extended from April to August 2005. One hundred and ten patients suffering from chronic renal failure (CRF) were admitted into the study, fifty five urine samples were collected from patients diagnosed as chronic renal insufficiency and treated by conservative management. The other fifty five samples were collected from patients diagnosed as end stage renal disease and treated by haemodialysis.

Results: Out of 110 CRF Patients, the frequency of UTIs (significant bacteruria) was 33 (30%) while there were no significant bacteruria in 77 (70.0%) of patients. E. coli was the commonest isolated organism 17(51.6%). Followed by E. faecalis, Klebsiella, S. saprophyticus, S. aureus, Proteus mirabilis, Citrobacter davisea that represent 6 (18.3%), 3 (9%), 3 (9%), 2 (6.1%), 1(3%), and 1(3%) respectively

Conclusion: frequency of UTIs (significant bacteruria) and significant pyuria were 30% and 42.7% respectively. This frequency of UTIs was higher in haemodialysis than those on conservative management patients. The pyuria had high sensitivity and specificity in detection of significant bacteruria and so can use as screening test in patients suspected of having UTIs including CRF patients.