Acute Kidney Injury Among Patients with Multi-Drug Resistant Infection: A Study from Jordan

Abstract

Background

Acute kidney injury (AKI) is a well-known complication for hospitalized patients. Sepsis and various infections play a significant role in increasing the incidence of AKI. The present study evaluated the risk for Multidrug-resistant (MDR) infections and its effect on the incidence of AKI, hospitalization, need for dialysis, and mortality.

Methods

In a retrospective study design, data were collected from all adult patients with a positive multi-drug resistant culture who were admitted to King Abdullah University Hospital (KAUH). Records of 436 patients were reviewed between January 2017 – December 2018 with at least one year of follow-up.

Results

The mean age was 57.3 years (SD± 23.1), and 58.5% were males. The most common source of positive cultures was sputum, with 50% positive cultures. The incidence of AKI was 59.2%. The most isolated microorganism was Acinetobacter baumannii (76.8%), followed by Pseudomonas aeruginosa (14.9%).On multivariate analysis, age (OR 1.1, 95% CI 1.1–1.2, P=0.001), HTN (OR 1.8, 95% CI 1.0–3.3, P=0.02), DM (OR 1.1, 95% CI 0.6–1.9, P=0.69) and the use of Foley catheter on chronic bases (OR 4.3, 95% CI 2.6–6.8, P<0.0001) were strong predictors of AKI. Among patients with AKI, 74.4% died compared to 44.4% among non-AKI patients (p<0.001).

Conclusion

In patients with MDR, AKI incidence, hospitalization, and mortality were high. Early detection and addressing the problem may decrease bad outcomes, and health education for reducing antibiotic abuse is needed to lower MDR.

Keywords:

• infection
• multi-drug resistant
• mortality
• acute kidney injury

Ethics and Patient Consent

Institutional approval was obtained from the Institutional Review Board at King Abdullah University Hospital, Internal IRB number 489/2020. This study was conducted by the Declaration of Helsinki and all its amendments. Patients’ data confidentiality was ensured as per international standards. Due to the retrospective study design and the expected high mortality rate among patients enrolled, the IRB agreed to waive informed consent for this study.

Acknowledgment

We would like to thank Jordan University of Science and Technology / Deanship of Research for their continuous support.

Disclosure

The authors report no competing interests in this work.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.