Organisms Isolated and Their Antibiotic Sensitivity Pattern from Renal Transplant Recepients in Kidney Transplant Unit

Aim: Despite improvements on immunosuppressive therapy and surgical techniques, infections remain important complication in renal transplant and have been associated with increased morbidity and graft rejection. Role of microbiological cultures in isolating bacteria and formulating their antibiogram has potential benefits with regards to targeted therapy for MDR bacteria. No such study has been conducted previously from this region so we designed this study to find out the organisms causing infections in renal transplant patients and their antibiotic susceptibility pattern.

Materials and Methods: This retrospective study was conducted over a period of 1 year from 2016 to 2017. All samples were sent from Kidney Transplant Unit (KTU) for culture and sensitivity irrespective of duration of post renal transplant. Qualitative culture of other infected body fluids was performed on blood agar, MacConkey agar plate (Hi media, India). Positive cultures were processed for antimicrobial susceptibility testing on Mueller-Hinton agar plates, using the Kirby-Bauer disk diffusion method, according to the CLSI guideline.

Results: A total of 81 samples were received from kidney transplant unit for culture, out of which 48 (59.2%) were sterile and 33 (40.8%) were culture positive samples. Urinary tract infection (UTI) (69.6%) was the most common infection followed by wound infection (21.2%) and respiratory tract infection (9.09%). In our study most common organism isolated from UTI was Escherichia coli (30.3%), followed by K. pneumoniae, (21.2%), MRSA (Methicillin resistant Staphylococcus aureus) (18.2%), Acinetobacter spp. (9.1%), Enterococcus spp. (12.1%), Pseudomonas aeruginosa (6.1%), Streptococcus pyogenes (3%). Antibiotic susceptibility of different organism isolated during culture showed that all strains of Escherichia coli identified were sensitive to amikacin and none of the strains was resistant to it.

Conclusions: To conclude, UTI was the most common infection followed by wound infection and respiratory tract infection. The most prevalent organism in UTI patients was Escherichia coli and its in vitro antibiotic susceptibility was highest to amikacin (100%) and resistant to cephalosporin, quinolones. The incidence of MRSA was found to be higher as compared to the other studies and needs to be kept in mind while treating transplant recipients.