Chronic Kidney Disease—An Underestimated Risk Factor for Antimicrobial Resistance in Patients with Urinary Tract Infections

Văcăroiu, Ileana Adela; Cuiban, Elena; Geavlete, B.; Gheorghiță, Valeriu; David, Cristiana; Ene, Cristian; Bulai, C.; Lupusoru, Gabriela Elena; Lupuşoru, Mircea; Balcangiu-Stroescu, Andra Elena; Feier, Larisa Florina; Simion, Ioana Sorina; Rădulescu, Daniela

doi:10.3390/biomedicines10102368

Cited by 6 publications

(3 citation statements)

References 34 publications

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“…According to the World Health Organization, one of the biggest threats to global health is antimicrobial resistance, with a continuous decline in the number of effective molecules against bacteria [17,18].…”

Section: Introductionmentioning

confidence: 99%

Confronting a New Challenge in Plastic Surgery: MDR Infections in Patients with Chronic Wounds

Răducu,

Moraru,

Gheoca-Mutu

et al. 2024

Life

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Background: The presence of a wound can be anywhere from non-problematic to life-threatening on a severity spectrum, with bacterial infection and resistance playing a major role in the development of chronicity, delaying wound healing. Wound colonization with multiple organisms and the limited number of effective antibiotics place a heavy burden on the healthcare system, with patients going through multiple surgeries during a prolonged hospitalization time. By analyzing the resistance patterns of pluri-bacterial populations and the approach used in managing complex cases, we aim to improve the protocols applied in caring for chronic wounds in our practice and share our experiences and observations. Methods: We designed a retrospective study on 212 diabetic and non-diabetic patients, aiming to evaluate the course of chronic wound treatment in our practice. We focused on the impact that MDR bacteria and diabetes have on surgical outcomes and their role in the healing process. Results: Patients who received empiric antibiotic therapy before being admitted eventually presented with multiple MDR bacteria compared to those who did not receive antibiotics (p = 0.014). The presence of at least one MDR bacteria in the wound bed was associated with ulcers reaching bone (p = 0.02) and was positively correlated with the number of surgeries performed (p < 0.001). Diabetes played a significant role in surgery-related complications (p = 0.02) and hospitalization time (p < 0.001). Conclusions: Proper management of chronic wounds requires a comprehensive, multidisciplinary approach and a thorough understanding of antibiotic usage. To address this need, we have developed and implemented a chronic wound treatment protocol in our clinic, with the goal of discharging patients once their ulcers have been treated and closed. A key summary of the protocol presented is to reduce the incidence of MDR bacteria and improve the patient’s quality of life.

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Section: Introductionmentioning

confidence: 99%

Confronting a New Challenge in Plastic Surgery: MDR Infections in Patients with Chronic Wounds

Răducu,

Moraru,

Gheoca-Mutu

et al. 2024

Life

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“…To the best of our knowledge, the present study was the first to evaluate angiogenetic mechanisms in hypoxic conditions in patients with prostate tumours, correlated with common clinicopathologic variables (48). However, some limitations should be noted.…”

Section: Discussionmentioning

confidence: 89%

Angiogenic systemic response to the hypoxic microenvironment in prostate tumorigenesis: A pilot study

Cosmin,

Ilinca,

Daniela

2023

Exp Ther Med

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The present paper aimed to investigate the altered angiogenetic mechanisms in hypoxic conditions in patients with prostate tumours, in correlation with common clinicopathologic variables. A case-control study was developed and included 87 patients with prostate tumours [40 diagnosed with benign prostatic hyperplasia (BPH) and 47 diagnosed with prostate cancer (PCa), using prostate transrectal biopsy] and 40 healthy subjects. The following parameters were evaluated in the serum of volunteers: Hypoxia-inducible factor (HIF)-1α, fibroblast growth factor (FGF)-2, vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMP)-2 and -9, thrombospondin (TSP)-1 and soluble VEGF-1 receptor. Experimental data analysis demonstrated increasing amounts of inflammation in patients with PCa (IL-6, 18.1±4.7 ng/ml) and BPH (IL-6, 16.3±5.1 ng/ml) vs. control (IL-6, 4.1±1.2 ng/ml); overregulation of HIF1α in patients with PCa (129.3±21.8 ng/ml) compared with patients with BPH (65.6±18.2 ng/ml) and control (61.3±12.7 ng/ml); angiogenesis abnormalities in patients with PCa (upregulation of FGF-2, VEGF, MMP-2 and -9, suppression of TSP-1 and soluble VEGR-1) and BPH (upregulation FGF-2 and VEGF) compared with the control group. In conclusion, a greater understanding of the biological mechanism, the pathological roles and the clinical significance of various proangiogenic parameters and angiogenic-suppressor proteins seem useful in clinical practice for establishing an early diagnosis of prostate pathology and finding an individualized therapeutic approach.

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“…CKD appears to be a health risk for bacterial infection brought on by pathogens that are resistant to antibiotics, but the majority of published studies are concentrated on the risk of MDR bacterial infections in patients with end stage kidney disease (ESKD) who are receiving dialysis, and there are few studies that examine the association between early stages of CKD and antibiotic susceptibility 34 .…”

Section: Resultsmentioning

confidence: 99%

Screening and Characterization of Multidrug Resistant Bacteria from Chronic Kidney Disease Patients of Warangal

Srilaxmi,

Munjam

2023

Biosci., Biotech. Res. Asia

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With an overall incidence of over 10% within regular population, Chronic kidney disease is an issue that is becoming more and more important in terms of public health. The enhanced risk of infection, especially those brought on by bacteria that are multi-drug resistant, is one of the main side effects of chronic kidney disease. It is essential to screen and identify multidrug resistant bacteria in chronic kidney disease patients, especially those receiving haemodialysis, in order to prevent the transmission of these pathogens. Hence, to improve outcomes for chronic kidney disease patients, early diagnosis and prompt treatment of drug-resistant bacteria are essential. A total of 2219 samples were screened for antibiotic resistant microbes in hospital samples. 445 samples tested positive (20.05 %) for bacterial growth and 1774 samples tested negative (79.94 %). The rate of multidrug resistance bacterial infections was 17% and 43% higher in CKD patients for estimated glomerular filtration rate between 30 and 59 ml/min/1.73m2 and glomerular filtration rate 30 ml/min/1.73m2 respectively. Five bacterial isolates were found to exhibit multi-antibiotic resistance. The Multiple Antibiotic Resistance (MAR) Index ranged from 0.3 to 0.7 across the isolates. The isolates were identified as Enterobacter bugandensis, Enterococcus faecium, Providencia stuartii, Klebsiella variicola, and Escherichia coli by 16S rRNA gene sequencing and phylogenetic analysis. In conclusion, screening and identification of multidrug resistance bacteria is essential to prevent and control the spread of these pathogens and will be helpful for the effective treatment of the multidrug resistance in chronic kidney disease patients.

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Chronic Kidney Disease—An Underestimated Risk Factor for Antimicrobial Resistance in Patients with Urinary Tract Infections

Cited by 6 publications

References 34 publications

Confronting a New Challenge in Plastic Surgery: MDR Infections in Patients with Chronic Wounds

Confronting a New Challenge in Plastic Surgery: MDR Infections in Patients with Chronic Wounds

Angiogenic systemic response to the hypoxic microenvironment in prostate tumorigenesis: A pilot study

Screening and Characterization of Multidrug Resistant Bacteria from Chronic Kidney Disease Patients of Warangal

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