scholarly journals Epidemiology and Antimicrobial Susceptibility Pattern of Uropathogens in Patients with the Community- and Hospital-Acquired Urinary Tract Infections at a Tertiary Hospital in Somalia

2020 ◽  
Vol 13 (9) ◽  
Author(s):  
Abdikarim Hussein Mohamed ◽  
Mohamed Farah Yusuf Mohamud ◽  
Hussein Ali Mohamud
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Susceptibility ◽  
Resistance Rate ◽  
Susceptibility Pattern ◽  
Antimicrobial Susceptibility Pattern ◽  
Sensitivity Rate ◽  
Tract Infections ◽  
Hospital Acquired

Background: Urinary tract infections (UTIs) are the most common infections in the community and in hospitalized patients. Objectives: To investigate the epidemiology and antimicrobial susceptibility pattern of uropathogens and determine the appropriate empirical antibiotics to treat UTIs in the community and hospitalized patients. Methods: A total of 2,485 urine cultures were performed at Mogadishu Somali Turkish Training and Research Hospital. Through the standard Kirby-Bauer disk diffusion method and commercial disks, antimicrobial sensitivity and resistance were studied based on the Clinical and Laboratory Standards Institute (CLSI) system using Mueller-Hinton agar. The identification of the microorganisms was done using eosin methylene blue agar and blood agar. Results: Escherichia coli was the most predominant pathogen (63.4%) in all age groups, both genders, and in the community and hospital-acquired UTIs, followed by Klebsiella pneumonia (13.3%). Ceftriaxone, trimethoprim/sulfamethoxazole, ampicillin, cefuroxime, and cefixime revealed the highest resistance level (82-100%) against uropathogens. Ciprofloxacin (67.7%) and levofloxacin (54.2%) showed increasing resistance rates against uropathogens. Tigecycline, colimycin, vancomycin, and teicoplanin exhibited the most powerful sensitivity rate (100%). Moreover, fosfomycin, nitrofurantoin, and amikacin manifested a significant sensitivity rate ranging from 86% - 95%. Acinetobacter baumannii was the most prevalent pathogen that belonged to multidrug- and extensively drug-resistant patterns in 69.1% of the samples. Escherichia coli and K. pneumonia showed similar multidrug-resistant patterns in 35.2% of the cases. Conclusions: The results indicated increased trends of antimicrobial resistance rate in trimethoprim/sulfamethoxazole (85.1%) and fluoroquinolones (61%) against E. coli that was higher than the recommended local resistance rate for empirical therapy (< 20% and < 10%, respectively). According to the results, using fosfomycin and nitrofurantoin are suggested for UTI empiric treatment, and other antibiotics should be prescribed carefully.

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
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Antimicrobial Susceptibility ◽  
Diabetic Patients ◽  
Susceptibility Pattern ◽  
Southwest Ethiopia ◽  
Antimicrobial Susceptibility Pattern ◽  
Tract Infections

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.

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