Multidrug resistance associated with acute kidney injury due to sepsis or systemic inflammatory response syndrome in intensive care unit patients

Abstract

Objective: Sepsis and systemic inflammatory response syndrome (SIRS) are the most common causes of acute kidney injury (AKI) in intensive care unit (ICU) patients. This study aimed to investigate the relationship of infection, the causative microorganisms and their antimicrobial resistance patterns in ICU patients with sepsis/SIRS with the presence of AKI. Material and Methods: The microbiological data of 109 ICU patients with sepsis/SIRS with serum creatinine level <2 mg/dl and without known history of renal disease were evaluated retrospectively. Results: AKI incidence in sepsis (52%) and in SIRS groups (57%) were similar. In total, 61% of the patients were septic and 157 microorganisms were isolated. The most frequently isolated bacteria was coagulase-negative Staphylococci (22%). Isolation rate of A. baumannii in samples of patients with AKI was significantly more compared to those of without AKI (p=0.03). although isolation rate of Pseudomonas aeruginosa was higher in AKI group, the difference was not statistically significant. Multidrug resistance was more prevalent in A. baumannii strains isolated from AKI patients, and foun as 61%. Conclusion: The resistant acinetobacter infections in ICUs are considered as a the most threatfull problems in most ICUs throughout the world. In our hospital's ICU, incidence of infection due to resistant A. baumannii was found in mostly in AKI patients. Since immunosupressed AKI patients are more vulnerable to infection, the proper control of infection and appropiate antibiotic treatment become crucial factors for a better outcome in ICUs, especially in AKI patients. © 2013 by Türkiye Klinikleri.