(1) Background: Chronic kidney disease (CKD), as well as antimicrobial resistance (AMR) represent major global health problems, with important social and economic implications. It was reported that CKD is a risk factor for antimicrobial resistance, but evidence is scarce. In addition, CKD is recognized to be a risk factor for complicated urinary tract infections (UTIs). (2) Methods: We conducted an observational study on 564 adult in-hospital patients diagnosed with urinary tract infections. The aim of the study was to identify the risk factors for AMR, as well as multiple drug resistance (MDR) and the implicated resistance patterns. (3) Results: The mean age was 68.63 ± 17.2 years. The most frequently isolated uropathogens were Escherichia coli strains (68.3%) followed by Klebsiella species (spp. (11.2%). In 307 cases (54.4%)), the UTIs were determined by antibiotic-resistant bacteria (ARBs) and 169 cases (30%) were UTIs with MDR strains. Increased age (≥65) OR 2.156 (95% CI: 1.404–3.311), upper urinary tract obstruction OR 1.666 (1.083–2.564), indwelling urinary catheters OR 6.066 (3.919–9.390), chronic kidney disease OR 2.696 (1.832–3.969), chronic hemodialysis OR 4.955 (1.828–13.435) and active malignancies OR 1.962 (1.087–3.540) were independent risk factors for MDR UTIs. In a multivariate logistic regression model, only indwelling urinary catheters (OR 5.388, 95% CI: 3.294–8.814, p < 0.001), CKD (OR 1.779, 95% CI: 1.153–2.745, p = 0.009) and chronic hemodialysis (OR 4.068, 95% 1.413–11.715, p = 0.009) were risk factors for UTIs caused by MDR uropathogens. (4) Conclusions: CKD is an important risk factor for overall antimicrobial resistance, but also for multiple-drug resistance.
1 January 2023 in Revista Romana de Medicina de Laborator
Background : Acute kidney injury is a severe complication of COVID-19. Both COVID-19 and related acute kidney injury are reported in the literature to be more prevalent and more severe in males. Methods : We performed a retrospective analysis of the COVID-19 associated acute kidney injury cases in order to search for differences between genders regarding patients’ and renal outcome. Results : 250 patients with acute kidney injury were included in the study: 93 women (37.20%), 157 men (62.80%). There were no differences between sexes regarding age. Diabetes mellitus was significantly more present in women. Peak ferritin and procalcitonin levels were significantly higher in men, but other severity markers for COVID-19 did not differ between genders. There were no differences between sexes regarding history of chronic kidney disease, timing of acute kidney injury, need for dialysis or recovery of renal function. ICU admission and in-hospital mortality were similar between men and women. Conclusions : In our study, COVID-19 related-AKI was more prevalent in men than in women, but the patients’ and renal outcome were similar. Significantly higher ferritin and procalcitonin serum levels registered in male patients when compared to women may have additional explanations beside more severe SARS-CoV-2 infection in males.