PLASMID-INDUCED ANTIBIOTIC RESISTANCE AMONG PATHOGENS OF CHRONIC PYELONEPHRITIS: PREVALENCE OF GENES AND MAJOR RISK FACTORS

Abstract

The aim of the study is to determine the prevalence of plasmid-mediated resistance genes among uro- pathogens from hospitalized patients with chronic pyelonephritis. Methods. A cross-sectional study of 105patients with chronic pyelonephritis and different stage of chronic kidney disease, was carried. Screening for the presence ofplasmid-mediated genes was performed by polymerase chain reaction. Determining the risk factors was performed by analysis of prevalence Odd-ratio. Results. The prevalence of plasmid-mediated resistance mechanisms among uropathogens is 36.7%, mainly due to extended-spectrum p-lactamase (25%). The main factors related with appearance of plasmid-mediated resistance genes were age range above 55 years (OR 3.05), hypertension (OR 2.57), Chronic Kidney Disease stage ІІІ (OR 2,03) and V (OR 1,1), in-patient treatment history (OR 2.02), duration of CP more than 10 years (OR 1,97), history of using antibiotics last year (OR 1,41). Conclusion. Isolation and detection of plasmid-mediated resistance mechanisms among urinary strains are essential for the selection of the most effective antibiotic for the empiric treatment.

Keywords

• chronic pyelonephritis, antibiotics, resistance, risk factors, plasmids.