Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute

Abstract

Background Urinary tract infections (UTIs) are the leading causes of morbidity in the general population, and is the second most common infectious disease after respiratory infections. Appropriate antibiotic therapy is essential to achieving good therapeutic results. Therefore, the purpose of this study was to investigate the profile of pathogens cultured from urinary tract infections and to determine their resistance profiles to commonly prescribed antibiotics. Method A cross-sectional study was carried out at the National Referral Laboratory of the Ethiopian Institute of Public Health from January 2017 to December 2018. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. The antimicrobial susceptibility test of the isolate was performed using the Kirby- Bauer disk diffusion test on Muller-Hinton agar. In addition, bacterial identification, antimicrobial susceptibility testing and phenotypic detection of MDR were performed with VITEK 2 Compact according to the manufacturer’s instructions. Result Out of 1012 cultured urine specimens, 325 (32.1%) was showed significant bacteriuria. The overall prevalence of UTIs was 325(32.1%) and the highest prevalence rate was obtained from 21–30 years age group 73(22.5%). Among UTIs patients, 583(57.6%) were females and 429(42.4%) were males. The UTIs of 179 (55%) women is relatively higher than that of men 146 (45%). Among 325 isolates, Gram-negative bacteria (GNB) appeared more frequently 252 (51.7%) than Gram-positive bacteria 63 (19.4%). In GNB, E. coli 168(66.7%), Klebsiella species 32(12.7%), and Enterobacter species 13 (5.2%) were dominated isolates whereas in GPB accounted for coagulase-negative staphylococcus (CoNS) 33(52.4%), Enterococcus species 16(25.4%), and Staphylococcus aureus 10(15.9%). Major of the isolates showed high levels of antibiotic resistance to commonly prescribed antimicrobials. Imipenem, Amikacin, and Nitrofurantoin were the most sensitive antibiotics for Gram-negative isolates while Nitrofurantoin, clindamycin, and Gentamycin were effective against gram-positive uropathogens. Overall, 156/256(60.9%), 56/256(22.4%), 10/256(4%) of gram-negative isolates were MDR, XDR, and PDR respectively while among the GPB isolates, 34/63(53.1%), 10/63(15.8%), and 1/63(1.6%) were MDR, XDR, and PDR isolates respectively. Among the tested bacterial strains, 190/319 (59.5%) were MDR, 66/319 (20.7%) strains were XDR, and 11/319 (3.45%) were PDR isolated. Conclusion The prevalence of urinary tract infection was high, and Gram-negative organisms were the most common causes of UTIs in this study. It was found that the resistance to commonly used antibiotics is very high. Early detection and close monitoring of MDR, XDR, or even PDR bacterial strains must be started by all clinical microbiology laboratories to reduce the menace of antimicrobial resistance that is now a global problem.

Magnitude and associated factors of bacterial urinary tract infections among paediatric patients in Arba Minch, southern Ethiopia

“…Among the Gram-positive bacteria, 58.8% of isolates were MDR, which is comparable to a study done in Gondar [ 21 ]. In this study, the overall percentage of XDR isolates was 15.8, which is comparatively lower than that reported in an earlier study in the country [ 18 ]. Results of the present study indicated that 57.1% (12/21) of Gram-negative bacilli were ESBL-positive.…”

“…Several emerging bacterial pathogens are extremely resistant to existing treatment regimens due to their physiology or growth characteristics, and uropathogens are of no exception [ 17 , 18 ]. Recently, bacterial uropathogens in the paediatric patient group became highly resistant to commonly used antibiotics such as ampicillin, co-trimoxazole, fluoroquinolones and the third generation cephalosporins, and these drugs became unsuitable for empirical use [ 19 ].…”

Antimicrobial Resistance Pattern of Clinical Isolates of Pseudomonas aeruginosa from Urinary Tract Infections in Wukari, Taraba state, Nigeria

“…In this study, a 17.39% prevalence of P. aeruginosa was reported among uropathogenic bacteria which is significantly higher than the 4% reported by Brown et al in asymptomatic UTIs in Wukari [22]. Similar studies have also reported lower prevalence rates of Pseudomonas aeruginosa in UTIs than that reported in this study [1,[23][24][25][26][27][28][29][30][31]. However, the reported prevalence is lower than the 18.70% reported in Egypt [32].…”

Bacterial uropathogens, their associated factors, and antimicrobial susceptibility pattern among adult diabetic patients in two health centers at Kombolcha town, Northeastern Ethiopia

“…Analogous results have revealed from earlier published studies: Addis Ababa (22.6%), 18 Gondar (17.8%), 15 Metu (16.7%), 14 Nekemete (16.5%), 34 Sudan (19.5%), 19 and Uganda (22.0%). 35 However, this finding was relatively lower as compared to the studies conducted in Arba Minch, Ethiopia (33.8%), 12 in Addis Ababa (32.1%), 36 Nigeria (40%), 37 Nepal (54.76%), 38 and Pakistan (49.2%). 39 On the contrary, our finding is higher than other studies conducted in Addis Ababa (10.9%) 21 and Dessie (11.6%).…”