What are the common uropathogens susceptible antimicrobials for nephrostomy patients?

Abstract

Introduction: Surgical procedures, such as nephrostomy, prone the patient to postoperative infection. Moreover, multidrug-resistant uropathogens emerge due to the inappropriate use of antibiotics and are now a progressive problem worldwide. Distribution mapping of uropathogens and antimicrobial susceptibility patterns in nephrostomy patients gives urologists a clearer picture to aid in better management of their patients. Objectives: To identify the distribution of uropathogens and antimicrobial susceptibility patterns in nephrostomy patients. Materials & methods: We conducted a retrospective observational review of the medical records, including all adult patients undergoing nephrostomy from 1st January 2020 until 31st December 2021 in a tertiary hospital in Yogyakarta, Indonesia. In each patient with a positive urine culture result, uropathogens and antimicrobial susceptibility test reports were recorded and evaluated separately. Results: Of 100 patients, 76 demonstrated positive urine culture (76%), with 78 isolates from 23 strains. Almost all strains were bacterial (22/23; 95.65%), but one was fungi (1/23; 4.35%). Escherichia coli was the most common uropathogens from the isolates (31/78; 39.74%), followed by Pseudomonas aeruginosa (10/78; 12.82%) and Klebsiella pneumoniae (6/78; 7.69%). Antimicrobial susceptibility tests of 33 antibiotics and 2 antifungals were carried out. Most reports showed susceptibility to Meropenem (11.78%), followed by Gentamicin (10.21%), amikacin (8.12%), and Nitrofurantoin (7.07%). Conclusion: The common uropathogens in nephrostomy patients were Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae. The common susceptible antimicrobials included Meropenem, Gentamicin, amikacin, and Nitrofurantoin.