scholarly journals Predictors of Surgical site infections among patients undergoing open urological surgery at a Tertiary hospital, Tanzania: A cross sectional study

2019 ◽  
Author(s):  
Joel Paschal Manyahi ◽  
Upendo Kibwana ◽  
Victor Sensa ◽  
Sydney C Yongolo ◽  
Eligius Lyamuya

Abstract Background Surgical site infection (SSI) is one of the major hospital acquired infections highly associated with prolonged hospitalization, morbidity and mortality. In open urological surgeries, little is known on magnitude and factors associated with development of SSI. Methods and Materials This was a cross-sectional prospective observational study performed between August 2015 and March 2016 at Muhimbili National hospital (MNH), Dar es Salaam, Tanzania. All patients who underwent open urological surgery and met inclusion criteria were consecutively enrolled, and followed up for 30 days. Patients´ and operative characteristics were recorded using standard structured questionnaires. Wound/ pus swabs were collected from patients with clinical evidence of SSI for bacteriological processing. Data analysis was performed using SPSS version 20. Results Of 182 patients who underwent open urological surgery, 22% developed SSI. Pre-operative urinary tract infection (aOR 9.73, 95%CI 3.93-24.09, p<0.001) and contaminated wound class (aOR 24.997, 95%CI 2.58-242.42, p = 0.005) were independent predictors for development of SSI. Shaving within 30 hrs before surgical procedure was found to be protective for developing SSI (aOR 0.26, 95%CI 0.09-0.79, p = 0.02). Escherichia coli (20/40) was the most predominant pathogen in SSI followed by Klebsiella pneumoniae (7/40) and S. aureus (6/40). Gram-negative bacteria were highly resistant to ceftriaxone, gentamicin, amoxicillin-clavulanic acid and trimethoprim-sulfamethoxazole. Conclusion SSI was high in open urological interventions. Pre-operative urinary tract infection and contaminated wound class predicted SSI. Bacteria causing SSI were highly resistant to commonly used antibiotics.

2021 ◽  
Author(s):  
◽  
Gerald Turyatunga

Background: A urinary tract infection (UTIs) is a common type of infection caused by bacteria that travel up the urethra to the bladder. Globally, it is reported that 150 million people are diagnosed with a UTI annually, costing the world economy over 6 million US dollars in treatment and work loss. Studies conducted in the in-patients pediatric ward of Muhimbili Hospital in Tanzania and Mulago National Referral Hospital in Uganda between five to ten years reported the prevalence of UTI to be 16.8% and 14.6% respectively. On average at Kam Medical Consult Clinic, patients who turn up in the laboratory are about 20%, and 50% of patients present with recurring UTIs clinically. Therefore,  there is a need to establish and investigate the prevalence of bacterial pathogens associated with UTI and multiple pathogens that are not known. Methodology: The cross-sectional study was carried out at Kam medical consult clinic (KMCC) located in Kafeero zone Mulago II Kawempe division. The study population was adults and children presenting with symptoms of urinary tract infection. 120 Midstream urine Samples were collected from patients presenting clinical signs of UTI. The diagnosis was done through macroscopy dry chemistry, microscopy, and culture. Results Among the sampled population, 33% of males had urinary tract infections while 67% of females had urinary tract infections.  88.5% were outpatients while 11.5 % were in-patients The overall prevalence of UTI among patients was 63.3% with children aged (1-10) having a prevalence of 5.8 %. Conclusion and recommendation: E.coli is an etiological agent causing UTIs in male and female patients presenting UTI at Kam Medical Consult Clinic. Other etiological agents included Klebsiella, Coliform, Enterococcus species, staphylococcus aureus, pseudomonas species, and candida species. There is a need to monitor the profile of etiological bacteria of UTI through culture and sensitivity regularly. 


Author(s):  
Setareh Sagheb ◽  
Ziba Mosayebi ◽  
Zahra Nikseresht

Background: Determination of contributing factors for jaundice would result in better programming for prevention. This study was performed to determine the prevalence rate of Urinary Tract Infection (UTI) among neonates with jaundice admitted in Arash Hospital from October 2013 to October 2014. Methods: In this descriptive cross-sectional study, term neonates with non-hemolytic jaundice admitted in Arash Hospital from October 2013 to October 2014 were evaluated for UTI by urine culture and the data were recorded by checklist using medical documents. Results: A total of 436 term infants were enrolled in the study. Mean age at the time of admission was 6.03±3.355 days with age range of 3-18 days including 291(0.66%) males and 145(0.33%) females. Urine culture was positive in 32 neonates (7.3%).The most common germs were Klebsiella in 37.5%, Escherichia coli (E. coli) in 21.9%, Staphylococcus in 9.4%, Pseudomonas in 3.1%, Enterococcus in 15.6%, Enterobacter in 9.4%, and Group B Streptococcus (GBS) in 3.1%. Conclusion: Urine culture should be a part of routine clinical evaluation for all icteric neonates at the age of 5-6 days or more who have no risk factors to exclude the possibility of coincidental UTI.


2013 ◽  
Vol 53 (2) ◽  
pp. 70
Author(s):  
Meirina Daulay ◽  
Rosmayanti Siregar ◽  
Oke Rina Ramayani ◽  
Supriatmo Supriatmo ◽  
Rafita Ramayati ◽  
...  

Background Urinary tract infection (UTI) is the most commoncause of fever in children. Less frequent disposable diaper changingis thought to be a cause ofUTI in children. While wearing a diapei;the perinea! area becomes damp with urine allowing bacteria tomigrate from the anus to the external urethral orifice.Objective To assess for an association between the frequencyof disposable diaper changing and urinary tract infections inchildren.Methods This cross-sectional study was conducted in thechildren's outpatient clinic of Haji Adam Malik Hospital fromApril to June 2010. Urine culture was performed in children withsuspected UTI who wore disposable diapers every day. Subjects'ages ranged from 2 months to 2 years 6 months, with samplesmatched and collected by consecutive sampling. Diagnosis ofUTIwas based on urine cultures with bacterial count 2:: 105/mL. Eightychildren were followed in this study and divided into two groups:positive (n=40) and negative (n=40) urine cultures. Chi squaretest was use d to analyze the association between the frequency ofdaily disposable diapers changing during a one week period andthe urine culture results.Results The frequency of daily disposable diapers changing in80 subjects was as follows: < 4 times (22.5%), 4-5 times (40%),and 2::6 times (37.5%) . The frequency of daily disposable diaperchanging in children with positive urine culture was as fo llows:< 4 times (1 8 out of 40), 4-5 times (22 out of 40), and 2::6 times(O out of 40); (P < 0.0001). The most common bacterial speciesfound in urine cultures was Escherichia coli.Conclusion Lower frequency of daily disposable diaper changingis significantly associated with higher UTI incidence in children.


2020 ◽  
Vol 58 (221) ◽  
Author(s):  
Arun Giri ◽  
Raju Kafle ◽  
Ganesh Kumar` Singh ◽  
Niraj Niraula

Introduction: Urinary tract infection is one of the commonest causes of childhood morbidity. Earlydiagnosis and appropriate choice of antimicrobials is essential. Hence, this study aims to identify theprevalence of Escherichia coli in childhood urinary tract infections. Methods: This was a hospital based descriptive cross-sectional study conducted in Nobel MedicalCollege, Biratnagar over a period of one year. A total of 163 cases aged 1-15 years were included andclinical profile, laboratory reports including bacterial isolates in urine cultures and their sensitivitypatterns were documented. Results: The prevalence of Escherichia coli is 45 (53.57%) C.I. Escherichia coli was the most commonorganism isolated in bacterial cultures followed by Klebsiella 12 (14.29%), Enterococcus 10 (11.90%).Urinary tract infection was common among females with male: female ratio of 1:2.3. Fever 152(93.2%) and abdominal pain 113 (69.3%) were the most common presenting symptoms. Escherichiacoli was found most sensitive to Nitrofurantoin 43 (95.5%) followed by Ciprofloxacin 41 (91.1%) andAmikacin 40 (88.8%). Conclusions: Urinary tract infections in childhood require prompt attention and treatment to preventsignificant morbidity and mortality. From this study it can be concluded that Escherichia coli is oneof the most common isolates in urine culture and Aminoglycosides and Fluoroquinolones can beaccepted as empirical treatment regimens for childhood Urinary tract infections.


F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 375
Author(s):  
Manoj Ghimire ◽  
Sudeep Adhikari ◽  
Kalpana Ghimire ◽  
Bishal Tiwari ◽  
Soni Koju ◽  
...  

Background: Urinary tract infection (UTI) is a common cause of hospital visits. There is an increasing trend of resistance of uropathogens to antibiotics worldwide. The aim of this study was to identify the common uropathogens, along with their antimicrobial susceptibility. Methods: This retrospective cross-sectional study was conducted from April 2018 to April 2020 at Beni hospital. All patients with urinary tract infection visiting Beni hospital during this time and who had urine culture sensitivity tests done were included in this study. Urine samples were first cultured on cystine lactose electrolyte-deficient agar by a semi-quantitative technique, and then incubated aerobically for 18–24 h at 37 °C. The identified bacterial isolates were tested for antimicrobial susceptibility by the Kirby–Bauer disc diffusion technique. Results: Of the 1173 samples, 164 (14%) samples showed significant growth. Escherichia coli (74%) was the most common causative organism. E. coli was sensitive in 113 cases (95%) out of 119. Amikacin was tested in 87 isolates that showed 99% sensitivity. Other commonly used antimicrobial agents had lower sensitivity rates: gentamicin (83%), ciprofloxacin (75%), ceftriaxone (59%), cefixime (56%), cotrimoxazole (55%), cefotaxime (41%), and ampicillin (38%). Conclusions: E.coli is the most common pathogen associated with urinary tract infection. Nitrofurantoin and amikacin can be good empirical agents for treating UTI in patients coming to Beni hospital.


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