Microbiological assay of respiratory infections in kidney diseases: a retrospective study in 2019

Background
Pneumonia is frequently encountered in patients with chronic kidney disease (CKD). Yet, little is known regarding its epidemiology and causative organisms in such patients. Hence, this study was conducted to evaluate the prevalence, risk factors, and microbiological causes of pneumonia in CKD patients.


Patients and methods
We retrospectively reviewed the data of 350 consecutive CKD patients who were divided into two groups; the first one included 50 CKD patients with pneumonia, and the second one included 300 ones who did not develop pneumonia.


Results
Pneumonia occurred in 50 patients (incidence rate = 14.29%). Patients who developed pneumonia tended to have older age, more prevalence of female gender, lower BMI, higher prevalence of other systemic comorbidities, longer disease duration, and higher CKD stage. Cough with expectoration was the most common presentation (72%), followed by tachypnea. Streptococcus pneumonia was the most common organism (34%), followed by klebsiella (16%). Other organisms included staphylococcus aureus (8%), Haemophilus influenza (6%), pseudomonas aeruginosa (4%), proteus (4%), and acinetobacter (4%), while mixed anaerobic organisms and fungi were detected in 8 and 4% of cases, respectively. ICU admission was required for 18 (36%) patients, while mechanical ventilation was done for 12 (24%) patients. Mortality was encountered in 11 (22%) cases.


Conclusion
The incidence of pneumonia is not low in CKD patients. Older age, female sex, smoking, diabetes mellitus, increased duration of CKD disease, and high CKD stage were independent predictors of having pneumonia in such patients.