DOI: https://doi.org/10.36347/sjams.2025.v13i11.004

Pages: 1817-1825

This prospective cross-sectional study was conducted at the Department of Nephrology, Bangladesh Medical University (BMU), Dhaka, Bangladesh over a period of four years from January 2020 to December 2023. A total of 1000 patients were evaluated to identify and analyze different categories of complicated urinary tract infections (cUTIs) along with their presentation, bacteriology, antibiotic sensitivity and treatment response. Their demographic profile, clinical presentations, obstructive features, co-morbidities, antibiotic sensitivity/resistant patterns and treatment responses were all documented appropriately. Their mean age was 36±4 years and 54.5% were female. Most of the cUTI cases (80%) presented with dysuria followed by hematuria (35%), flank or suprapubic pain (30%) and urgency (30%). Majority patients (72z%) with cUTI had neutrophilic leukocytosis, elevated C-reactive protein (CRP) had 80% study cases and bacterial colony count >105 cfu/ml. was found in 82% cases. Upper UTI was observed in 78% cases and lower UTI was in 22% patients. The major types of cUTI were acute pyelonephritis (52%) then acute complicated cystitis (12%), acute emphysematous pyelonephritis (3%), pyonephrosis (1.5%) and urosepsis (1%) were detected. Normal renal function was observed in 55% patients, remaining showed different grades of renal impairment. The most frequent anatomical abnormalities were Autosomal Dominant Polycystic Kidney Disease (ADPKD) and pelvic kidney. Various types of obstructive features were observed in the study population. Diabetes mellitus was the leading co-morbidities among patients with cUTI. Escherichia coli (E. coli) was detected as the major pathogenic bacteria in 48% cases. Among gram positive bacteria Staphylococcus aureus was detected in 6% cases. Antibiogram showed Colistin, Meropenem and Tegecycline, had highest degree of antibacterial sensitivity against E-coli (85.5%). Staphylococcus aureus was sensitive to Linezolid (92%) and Vancomycin (84%). Pse