#4022 RETROSPECTIVE ANALYSIS OF SPECTRUM OF INFECTIONS AND ANTIBIOTIC RESISTANCE PATTERN IN HEMODIALYSIS PATIENTS IN A TERTIARY CARE CENTRE IN NORTH INDIA

Abstract

Abstract Background and Aims Hemodialysis patients are at risk of infections due to various factors. Antibiotic resistance is an ever-changing issue. Initial empirical therapy depends on local epidemiology of infection, and antibiotic resistance pattern. Non-access related infections received lesser research attention worldwide. This study examines the spectrum of infections, and antibiotic resistance pattern. Method We retrospectively reviewed the records of 586 hemodialysis patients from May 2018 to April 2020 in a tertiary care hospital in North India. Results The study identified 99 episodes of confirmed infections. Urinary tract infections were the most common type of infections (55.5%), followed by Catheter-related blood stream infections (CRBSI) (definitive 21.2%). Other infections were pneumonia (8.1%), tuberculosis (6.1%), skin and soft tissue infection (4.0%), dengue fever in (3.03%) and empyema thoracis (1.0%). Overall, Escherichia coli (33.3%) was the most common organism isolated. The most frequent uropathogens recovered were Escherichia coli (54%). In confirmed CRBSI, P. aeruginosa (23.8%) and MSSA (23.8%) were the most common pathogen isolated. K. pneumonia (37.5%) was the most common pathogen in pneumonia. Uropathogens showed highest resistance to fluoroquinolones (93.3-100%). Pathogens isolated in CRBSI shown maximum resistance to ciprofloxacin (100%). In pneumonia, highest resistance was seen to third generation cephalosporins (75-100%). Conclusion Though bacterial spectrum remains the same over time, antibiotic resistance is changing in uropathogens. There is a trend of predominance of gram-negative bacterial infections in CRBSI. Tuberculosis incidence rate was much higher than the general population. There is a need for nationwide and worldwide continuous surveillance.