scholarly journals Prevalence, Antimicrobial Susceptibility Pattern, and Associated Factors of Urinary Tract Infections among Adult Diabetic Patients at Metu Karl Heinz Referral Hospital, Southwest Ethiopia

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Tesfaye Gutema ◽  
Fitsum Weldegebreal ◽  
Dadi Marami ◽  
Zelalem Teklemariam

Urinary tract infection causes considerable morbidity in diabetic patients and if complicated, can cause severe renal damage and life-threatening infections. The escalating antimicrobial resistance rate among bacteria over the past years is another concern in the treatment of urinary tract infections. This study investigated the prevalence, antimicrobial susceptibility pattern of the isolates and associated factors of urinary tract infection among adult diabetic patients attending Metu Karl Heinz Referral Hospital, Southwest Ethiopia. An institutional-based cross-sectional study was conducted among 233 adult diabetic patients selected using simple random sampling technique. Data were collected using a structured questionnaire. Clean-catch midstream urine samples were investigated for the presence of pathogenic bacteria and their antimicrobial susceptibility pattern using recommended culture methods. Data were entered, cleaned, and analyzed using the Statistical Program for Social Sciences version 21.0. Statistical significance was set at ap-value < 0.05. The prevalence of urinary tract infection was 16.7% (95%, CI: 12.0, 21.5). The predominant isolates wereEscherichia coli(25.6%) andKlebsiellaspp. (20.5%).E. coliisolates showed higher sensitivity to ceftriaxone (80%), ciprofloxacin (70%), and gentamycin (70%), but resistant to tetracycline (60%).Staphylococcus aureuswas sensitive to amoxicillin-clavulanic acid (85.7%), and gentamycin (57.1%), while resistant to tetracycline (85.7%), nitrofurantoin (85.7%), and ampicillin (71.4%). The odds of developing urinary tract infections were significantly higher in diabetic females (AOR: 3.56, 95% CI: 1.44, 8.76), those who were not able to read and write (AOR: 2.55, 95% CI: 1.19, 5.49) and those with a history of urinary tract infection (AOR: 2.31, 95% CI: 1.09, 4.90) compared with their counterparts. In this study, the prevalence of urinary tract infection among diabetic patients was relatively comparable with the previous studies conducted in Ethiopia. Management of urinary tract infection in diabetic patients should be supported with culture and antimicrobial susceptibility testing.

2021 ◽  
Author(s):  
Berhanu Adugna ◽  
Bekele Sharew ◽  
Mohabaw Jemal

Abstract Back ground: Urinary tract infection are one of the most common bacterial infections in the community and in the hospital. Nowadays, little is known about the status of community and hospital acquired urinary tract infection, antimicrobial susceptibility pattern and associated factors among urinary tract infection patients in Ethiopia, particularly in our study area. Methods A hospital based cross sectional study was carried out in Dessie referral hospital. A total of 422 urine samples were enrolled using systematic random sampling technique. All isolates were identified by standard microbiological techniques and their antibiotic susceptibility was done by Kirby Bauer disc diffusion method. Data was entered using Epi data version 3.1 and analyzed by SPSS software version 20. P- Value < 0.05 at 95% CI was considered as statistically significant. Result Of 422 urine samples processed 100 (23.7%) yielded bacterial isolates. About50(30.7%) and 50(19.3%) samples from hospitalized and community showed significant bacteriuria respectively. E. coli 44/103(42.7%), predominated across the two groups followed by S. aureus 25/103(24.3%), CONs,14/103(13.5%), Klebsiella spps 7/103(6.78), proteus spps 3/103(2.91), and Entrococcus spps 3/103 (2.91%). Pseudomonas spps 3/103 (2.91), Citrobacter spps 2/103(1.94%) and Acinetobacter Spp 1/103(0.999), which were isolated from only the hospitalized samples. Meropenem susceptibly was 100% in both study groups and Ampicillin resistance was documented as 83.3–100% and 76.9–100% in hospitalized and community acquired respectively. Among risk factors previous use of antibiotics, female gender, Age, Diabetics, catheterization were associated with the infection. Conclusion The present study revealed that slightly high prevalence of urinary tract infection. High antimicrobial resistance was observed to most antimicrobial drugs tested. Meropenem and Nitrofurantoin were the most active drugs for urinary tract infection. Empirical selection of antimicrobial agents should be based on antibiotic sensitivity pattern of uropathogens that prevalent in that area. Female sex, age, previous use of antibiotics, catheterization and diabetics were at risk of urinary tract infection.


Author(s):  
Dadi Marami ◽  
Senthilkumar Balakrishnan ◽  
Berhanu Seyoum

Urinary tract infection remains a major public health problem in developing countries, where there are limited health-care services. Its prevalence is fueled by human immunodeficiency virus (HIV) infection. The emergence of antimicrobial resistance is now widespread and poses a serious clinical threat. This study investigated the prevalence, antimicrobial susceptibility pattern of bacterial isolates, and associated factors of urinary tract infections among HIV-positive adult patients. A cross-sectional study was conducted among 350 randomly selected HIV-positive patients at Hiwot Fana Specialized University Hospital from February to March 2016. Data were collected using a structured questionnaire. Clean-catch midstream urine samples were collected aseptically and examined using the recommended culture methods. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion technique. Data were analyzed using Statistical Package for the Social Sciences version 21.0. The logistic regression models were used to explore the predictors of the outcome. A p value < 0.05 was considered statistically significant. The overall prevalence of urinary tract infection was 18% (95% CI: 15.34–22.63). Individuals with age 35–44 years (Adjusted odds ratio (AOR): 4.07; 95% CI: 1.09, 5.10), income less than 46.7 USD (AOR: 2.76; 95% CI: 1.15, 6.07), and a CD4+ count less than 200 cells/mm3 (AOR: 2.07; 95% CI: 1.15, 3.73) had higher odds of UTI. Escherichia coli (38.1%), Klebsiella pneumoniae (23.8%), and Staphylococcus aureus (11.1%) were the predominant causes of urinary tract infection. E. coli was resistant to ampicillin (95.8%), ceftazidime (95.8%), cotrimoxazole (95.8%), amoxicillin (91.7%), ceftriaxone (87.5%), and tetracycline (87.2%). Multidrug resistance was observed in 46% of the isolates. The prevalence of urinary tract infection in this study was high compared to the previous reports in Ethiopia. Age 35–44 years, income less than 46.7 USD, and a CD4+ count < 200 cells/mm3 increase the odds of urinary tract infection. The most common isolates were E. coli, K. pneumoniae, and S. aureus. Almost half of the isolates were multidrug resistant. Actions to help mitigate the further spread of resistance are urgently needed in the study area.


2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Ibtesam Salih Abdulrahman

Urinary tract infections represents one of the most common diseases encountered in medical practice affecting people of all ages from the neonate to the geriatric age group. The aim of this study was to determine and evaluate the antimicrobial susceptibility patterns for most common strains of bacterial urine isolates taken from patients at Azadi teaching hospital laboratories in Duhok city/Kurdistan region in Iraq, for two years (2014 and 2015). A retrospective survey study was conducted and 1003 data of urine culture sensitivity test were collected from recorded archives of the Azadi hospital of two years; 2014 and 2015.  The study included all recorded positive urine samples cultures isolated from inpatients and outpatients. Results revealed that the female to male ratio for urinary tract infection was 2.7:1 and the most common microorganisms isolated were Escherichia coli (52%), Staphylococcus aureus (11%), Staphylococcus haemolyticus (9.6%) and Klebsiella pneumoniae (8.1%). In general maximum sensitivity was seen for Meropenem (94.9%), followed by Imipenem (89.7%) and Ertapenem (88.7%). The maximum resistance was seen against Cefazolin (79.7%) and Amoxicillin/clavulanic acid (77.5%). The antibiotic sensitivity pattern of E. coli reveals that the maximum sensitivity was seen for Meropenem (97.3%) and Imipenem (95.6%). The maximum resistance was seen against Amoxicillin/clavlanic acid (83.1%). The resistance against many commonly used antibiotics have been increased which limit the options for treating urinary tract infection. This is resulted from uncontrolled use of the antibiotics and lack of policies and guidelines for their use in public health. 


2020 ◽  
Author(s):  
Adugna Fenta ◽  
Mulat Dagnew ◽  
Setegn Eshetie ◽  
Teshome Belachew

Abstract Background: Urinary tract infection is one of the most common bacterial infections in children. Understanding the characteristics of uropathogens and their antimicrobial susceptibility pattern in a particular setting can provide evidence for the appropriate management of cases. This study aimed to assess the bacterial profile of urinary tract infection, their antimicrobial susceptibility pattern and associated factors among clinically suspected children attending at Felege-Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia.Methods: A hospital-based cross-sectional study was conducted from February-April, 2019. A systematic sampling technique was employed. A mid-stream urine sample was inoculated on cystine lactose electrolyte deficient media and incubated for 24-48 hours. Sub-culturing was done on Mac-Conkey and blood agar. Antimicrobial susceptibility test was done on Muller-Hinton agar. A binary logistic regression model was used to see the association between dependent and independent factors. A p-value<0.05 at 95% CI was considered as statistically significant.Results: The overall prevalence of urinary tract infection was 16.7% (95% CI 12.4-21.1). Both Gram-negative and Gram-positive bacterial isolates were recovered with a rate of 44/50 (88%) and 6/50 (12%) respectively. Among Gram-negative isolates, E. coli 28/44(63.6%) was predominant while S. saprophyticus 2/6(33.3%) was prevalent among Gram-positive bacterial isolates. Overall, a high level of resistance to ampicillin, augmentin, and tetracycline was shown by Gram-negative bacteria with a rate of 44/44(100%), 39/44(88.6%), and36/44 (81.8%) respectively. About 33/50(66%) of overall multidrug resistance was observed (95% CI 52-78). About six Gram-negative bacterial isolates were extended spectrum beta-lactamase (ESBL) producers. Having a history of urinary tract infection (P-0.003, AOR 1.86-22.15) and male uncircumcision (p-0.00, AOR 5.5-65.35) were the independent variables that associate for urinary tract infections.Conclusion: In the present study, the prevalence of urinary tract infection among children was high and considerably a high proportion of multidrug resistance was observed. This result will have a significant impact on the selection of appropriate antimicrobial agents for the treatment of urinary tract infection.


Author(s):  
Akhilesh Kumar ◽  
Rajiv Kumar ◽  
Manju Gari ◽  
Uma Shanker P. Keshri ◽  
Sumit K. Mahato ◽  
...  

Background: Urinary tract infection (UTI) is one of the common infections encountered by the clinicians. Though a good number of antimicrobial agents are available, still UTIs have become difficult to treat due to development of resistance by the uropathogens. So, regional data regarding the common uropathogens and their sensitivity pattern is required to guide the clinicians to start empirical therapy while managing UTIs. The purpose of the study was to identify different species of microorganisms, along with their antimicrobial susceptibility pattern, causing urinary tract infection in outpatient and indoor patients at RIMS, Ranchi, Jharkhand.Methods: Observational study was conducted using urine culture and sensitivity reports collected retrospectively from records maintained in the department of Microbiology over a period from July 2016 to Feb 2017 in tertiary care hospital.Results: UTI was more common in females (57.74%) than in males (42.26%). Among the uropathogens isolated Escherichia coli (37.41%) was found to be the predominant organism followed by Klebsiella species (32.79%), Pseudomonas species (25.86%), and gram-positive bacteria Staphylococcus aureus accounted (3.92%) of total cases. The most common isolates were E. coli showed high sensitivity to amikacin (79.24%), followed by levofloxacin (77.21%) and gentamycin (62.26%). It was found to be resistant to norfloxacin (86%), nalidixic acid (86.76%) and cefotaxime (69.88%).Conclusions: Though various microorganisms are responsible for UTI. Escherichia coli species is the most common organism. Antimicrobial resistance has already emerged against many antibiotics, making empirical treatment of these infections challenging.


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