Volume : 08, Issue : 01, January – 2021
THE ROLE OF EXTENDED-SPECTRUM BETA-LACTAMASE PRODUCING ORGANISMS CAUSING URINARY TRACT INFECTION IS A RISK FACTOR FOR ACUTE KIDNEY INJURY AMONG TYPE 2 DIABETIC PATIENTS
Matiullah Alam, MD Sakil, Manoj Kumar Yadav
Background: Urinary tract infection (UTI) is common, and diabetic patients are at increased risk of UTI. A UTI can be complicated by acute kidney injury (AKI). This study was designed to assess whether UTI induced by microorganisms producing ed-spectrum beta-lactamase (ESBL) should be considered a risk factor for AKI in patients with type 2 diabetes.
Methods: This case-control study was conducted at the Internal Medicine and Nephrology of Jalalabad Ragib Rabeya Medical College and Hospital, Bangladesh for one-year duration from June 2019 to June 2020. Type 2 diabetes patients with culture-confirmed UTIs were assessed. Patients with UTI complicated by AKI were cases and those without AKI were treated as controls. The positivity of the isolated organisms to ESBL was assessed as a risk factor for AKI.
Results: During the study period, a total of 131 patients with type 2 diabetes (male to female ratio 1: 2.6) with inoculated UTIs were enrolled. The mean age and duration of diabetes were 56.1 ± 13.3 and 8.7 ± 5.4 years, respectively. The most common etiological factor was Escherichia coli (82, 62.6%), followed by Klebsiella pneumoniae (14, 10.7%). Two-thirds (55/82, 67.1%) of E. coli and two-fifths (6/14, 42.9%) of Klebsiella were ESBL-positive. UTIs in 64 (48.9%) patients were caused by ESBL-positive microorganisms. Of 131 patients with a UTI, 62 (47.3%) had AKI; 40 (40/64, 62.5%) among ESBL-positive organisms and 22 (22/67, 32.8%) among non-ESBL organisms. There was no significant difference in age (p = 0.71), gender (p = 0.26), diabetes duration (p = 0.37) and glycosylated hemoglobin (HbA1c) (p = 0.69) between patients and a control group. The positivity of ESBL appeared as a significant risk factor for AKI among the respondents (OR = 3.4, 95% CI = 1.66-6.99, p = 0.008).
Conclusions: Almost half of the type 2 diabetic patients with UTI in this study had ESBL-positive microorganisms as etiological factors. UTIs caused by ESBL-positive organisms were a significant risk factor for AKI. Key words: Acute kidney injury, broad spectrum beta-lactamase, risk factor, type 2 diabetes, urinary tract infection.
Keywords :Acute kidney injury, broad spectrum beta-lactamase, risk factor, type 2 diabetes, urinary tract infection.
Cite This Article:
Please cite this article in press Matiullah Alam et al, The Role Of Extended-Spectrum Beta-Lactamase Producing Organisms Causing Urinary Tract Infection Is A Risk Factor For Acute Kidney Injury Among Type 2 Diabetic Patients., Indo Am. J. P. Sci, 2021; 08(01).
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