Magnitude and antimicrobial susceptibility profiles of Gram-Negative bacterial isolates among patients suspected of urinary tract infections in Arba Minch General Hospital, southern Ethiopia

Abstract

The emergence of drug-resistant Gram-negative bacterial uropathogens poses a grave threat worldwide, howbeit studies on their magnitude are limited in most African countries, including Ethiopia. Therefore, measuring the extent of their drug resistance is essential for developing strategies to confine the spread. A cross-sectional study was conducted at title hospital from 01 June to 31 August 2020. Midstream urine specimens were collected and inoculated onto MacConkey agar. Positive urine cultures showing significant bacteriuria as per the Kass count (>105 CFU/mL) were further subjected to biochemical tests to identify the type of uropathogens. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion technique, and potential carbapenemase producers were phenotypically determined by the modified carbapenem inactivation method as per the CLSI guidelines. Data were analyzed using SPSS version 26; P-value <0.05 was considered statistically significant. Totally, 422 patients were included, and the majority were females (54.7%). The prevalence of carbapenem-resistant Gram-negative uropathogens was 12.9%, and 64.7% of them were carbapenemase producers. Klebsiella pneumoniae (n = 5) was the predominant carbapenemase producer, followed by Pseudomonas aeruginosa (n = 4). Consumption of antibiotics prior to six months of commencement of the study, the presence of chronic diseases and hospitalizations were statistically associated with UTI caused by carbapenem-resistant Gram-negative uropathogens. Carbapenemase producers were resistant to most of the antibiotics tested. Our findings highlight the need for periodic regional bacteriological surveillance programs to guide empirical antibiotic therapy of UTI.

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

“…Multiple drug resistance exhibited by bacterial pathogens, is a growing global public health threat culminating in frequent and prolonged hospitalizations, loss of manpower, greater morbidity and mortality, and enhanced healthcare costs [ 42 ]. Indiscriminate and extensive consumption of several antibiotics can catalyze bacterial mutation creating resistance, and the resistant strains propagate exponentially under the selective pressure of antibiotics.…”

“…Indiscriminate and extensive consumption of several antibiotics can catalyze bacterial mutation creating resistance, and the resistant strains propagate exponentially under the selective pressure of antibiotics. A rising trend in the multi-drug resistance of uropathogens makes their management more challenging [ 42 ]. Strategies to prevent drug resistance include the judicious selection of antimicrobials, inspection of susceptibility patterns, as well as effective screening tests for checking the emergence of MDR strains.…”

Prevalence of meropenem-resistant Pseudomonas Aeruginosa in Ethiopia: a systematic review and meta‑analysis

“…Geographically, the studies were distributed across various regions of Ethiopia, with eight conducted in the Amhara region [ 26 – 33 ], three in Oromia [ 34 – 36 ], three in SNNPR [ 37 – 39 ], four in Addis Ababa [ 40 – 43 ], and one in Harari [ 44 ].…”

“…et al [ 30 ] 2020 Amhara 238 20 11 5 CS Hospital ICU Mixed Hospital Mekonnen et al [ 29 ] 2021 Amhara 254 33 18 3 CS Hospital ICU Mixed Hospital Alebel et al [ 27 ] 2021 Amhara 270 95 11 2 CS Hospital ICU Mixed Hospital Abdeta et al [ 40 ] 2021 AA 1337 429 36 7 CS Hospital Not defined Mixed Community Alemayehu. et al [ 38 ] 2021 SNNPR 103 111 8 3 CS Hospital Mixed Mixed Community Mitiku et al [ 39 ] …”

“…Et al [ 30 ] 0.20910977 0.0773275 0.34089205 Mekonnen et al [ 29 ] 0.14995179 0.09382511 0.20607847 Alebel et al [ 27 ] 0.14969699 0.09391756 0.20547643 Abdeta et al [ 40 ] 0.14658256 0.09069896 0.20246616 Alemayehu. Et al [ 38 ] 0.14505221 0.09029172 0.1998127 Mitiku et al [ 39 ] 0.14585564 0.09048406 0.2012272 Abda et al [ 26 ] 0.15089363 0.09481937 0.20696789 Bizuayehu et al [ 43 ] 0.15028805 0.09435938 0.20621672 Abayneh et al [ 37 ] 0.17417368 0.11178836 0.236559 Worku et al [ 33 ] 0.17417368 0.11178836 0.236559 Tilahun et al [ 32 ] 0.1223927 0.07197122 0.17281418 Beshah et al [ 41 ] 0.1467315 0.09193183 0.20153117 …”