Bacterial Urinary Tract Infection among Adult Renal Transplant Recipients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract

Background: Despite significant advances in surgical techniques, immunosuppression protocols follow up periods and antimicrobial stewardship in modern medicine; post-renal transplantation urinary tract infection remained a major public health problem globally. This multiple serious squeal includes asymptomatic bacteriuria, cystitis and pyelonephritis. Among these, the bacterial origin of infection complications accounts for the most significant clinical, socio-economic impacts in many countries of the world. Therefore, the aim of the study was to investigate the prevalence of bacterial isolates that cause urinary tract infections, assess antibiotic susceptibility pattern among symptomatic and asymptomatic renal transplant recipients attending at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: A hospital-based cross-sectional study was conducted from December 2017 to August 2018 among 74 renal transplant recipients St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. A first morning voided clean-catch mid-stream urine specimens were collected and 0.001ml inoculated onto blood and MacConkey agar plates following the standard bacteriological protocols. It was incubated aerobically at 35–37°C for 24–48 hours. Cultural characteristics and series of biochemical tests were used for the identification of isolates to species level. Results: Significant bacteriuria was found in 11/74 (14.9%, 95% CI =8.2-24.7) patients. The prevalence among females 6/32 (18.75%) was higher among males 5/42 (11.9%) without significant association (COR=2.09, 95% CI=1.04-8.45, P=0.253). Urinary tract infection was higher in the age group of 35–49 years old (19.3%). Age was statistically significant and stronger independent associated risk factor with crude odds ratio=3.67, 95% CI=2.89-20.07 and P= 0.003, respectively. The most prevalent bacteria isolates were Escherichia coli 2(18.2%), Staphylococcus aureus 2(18.2%), Acinetobacter spp. 2(18.2%), Enterococcus spp. 2(18.2%), Coagulase-negative Staphylococci 2(18.2%) followed by Portus mirabilis 1(9.1%). The majority (80%) of Gram-negative bacteria were resistant to ciprofloxacin, chloramphenicol, and trimethoprim/sulfamethoxazole. Conclusions: In conclusion, the overall prevalence of urinary tract infection in the study participants was relatively low with a prevalence of 14.9%. Majority of the study participants were asymptomatic. The multidrug-resistant bacterial isolates in the present study account for 82%. Keywords: Kidney Transplantation, Urinary Tract Infection, Antimicrobial Susceptibility Testing, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Etiology and Antimicrobial Susceptibility Pattern of Urinary Tract Infection in the First Year after Pediatric Renal Transplantation: A Preliminary Study

“…This finding represents the high prevalence of MDR uropathogens among renal transplantation recipients. In Kiros et al study, multidrug resistance was reported in 82% of the isolates among renal transplant recipients (30). In the study of Khosravi et al (31) , the most common resistance was reported against cefixime, cephalothin, and TMP/SMX, which was consistent with our results.…”

Bacterial Etiology of Urinary Tract Infection and Antibiogram Profile in Children Attending Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia

“…Since there was a high chance of contamination, urine samples collected using a collecting bag or pad were disregarded [27]. Ten, 5-10 ml of urine samples was taken from each research subject using sterile, screw-capped, wide-mouth containers and labeled with the patient's medical identifcation number [28]. Te urine sample was subsequently subjected to bacteriological testing using standard operating procedures [7,23,29].…”

“…Isolate identifcation to species level was done by their colony characteristics (size, shape, turbidity, and hemolysis), Gram staining, and pattern of biochemical profles. Te biochemical test was conducted to assess indole production, H2S production, lactose fermentation in TSI agar, citrate utilization, motility test, urease test, bile solubility, and lysine utilization in lysine decarboxylase( LDC) agar [28]. An oxidase test was also performed for other Gram-negative rods.…”