Urinary pathogenic bacterial profile, antibiogram of isolates and associated risk factors among diabetic patients in Hawassa town, southern Ethiopia: a cross-sectional study

Abstract

Urinary tract infection (UTI) is the commonest bacterial infectious disease in community practice with a high rate of morbidity and financial cost. It has been estimated that 150 million people were infected with UTI per annum worldwide which costing global economy more than 6 billion US dollar. In humans, urinary tract is the second commonest site after the respiratory tract, for bacterial infection. Two hundreds forty seven diabetic patients were investigated for UTI using 5 to 10ml midstream urine sample. A loop full urine sample was inoculated on cysteine lactose electrolyte deficient (CLED) agar, MacConkey agar and Blood agar plates. Antimicrobial susceptibility test was done using Clinical and Laboratory Standards Institute (CLSI) for all patients. Age, sex, resident, marital status and other factors were used as exposure factor of the cross sectional study. The aim of this study was to assess etiology, risk factors and drug sensitivity pattern of uropathogenic bacteria isolated from diabetic patients. The overall prevalence of significant bacteriuria was 26(10.5%). Significant bacteriuria was significantly associated with age and body mass index. The predominant bacteria isolate was E. coli 12(46.2%) followed by Coagulase negative staphylococcus 7(26.9%).Gram negative bacteria showed high rate of sensitivity (94.1%) to Nitrofurantoin and Norfloxacine. Gram positive bacteria showed 100% sensitive for Amoxacillin-Clavunic acid. Multidrug resistance to two or more drug was observed in 19(73.1%) of bacteria isolates. The overall prevalence of significant UTI in diabetic patients was 10.5%. The most frequently observed organisms were E. coli, CONs, K. pneumoniae, K. oxytoca and S. aureus. Sex, age, BMI, occupational status such as house wife was statistically significant. Gram negative bacteria isolates were the most common antibiotic resistant bacteria isolates from UTI patients.

Prevalence of Drug Resistant Uropathogenic <i>Escherichia coli</i> from Immunocompromised Diabetic Patients Attending Selected Health Facilities in Benue State

“…The results of antibiotic susceptibility pattern from Otukpo revealed E. coli to be moderately susceptible to streptomycin 60%, cefotaxime 55% and imipenem 50% while at the same time showing moderate to high resistance to cotrimoxazole 50%, tetracycline 55%, ceftriaxone 60%, ciprofloxacin 65%, ofloxacin 70%, nalidixic acid 70%, levofloxacin 80%, aztreonam 80%, ampicillin 80%. This was contrary to a study in India [36] who reported complete sensitivity (100%) to imipenem but comparable resistant pattern has been observed in Ethiopia to nalidixic acid 70% and cotrimoxazole 64.7% [26].…”

“…who reported 9.2%,10.1% recorded at Derbe Tabor General Hospital, Northwest Ethiopia[25] and 10.5% in Southern Ethiopia[26]. In contrast, much higher prevalence of 35.3% was reported in Iraq[27] 40.2% in Malaysia[28] and 54.7% in Nepal[29].The prevalence of UTI based on age group showed that age group 46 and 50 had the highest prevalence (33.9%) while age groups 18 and 25, 26 and 30, 31 and 35 had no recorded positive UTI cases.…”

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“…11 In the present study the overall prevalence of significant bacteriuria in diabetic patients was 10.5%. This is similar to the findings reported previously in Addis Ababa (10.9%), 6 Debre Tabor (10.9%) 12 and Romania (10.7%), 13 but lower than a study done in Gondar (17.8%) 4 and other studies done in Sudan (19.5%), 7 Nepal (21%), 14 Iraq (35.3%), 15 and Pakistan (51%). 16 This variation in prevalence might be due to the difference in sample size, geographical location, personal hygiene, and variation in the screening test used.…”

“…4 In other hand it is contradicting with a study done in Addis Ababa 28%, 6 Sudan (23%), Uganda (28.6%), India (20%), Iraq (15.1%) and Nepal (21.6%). 7,11,15,21,22 The higher isolation rate of CONs in this study could be change in pattern of infection in diabetic patients. 11 In the present study BMI >=30kg/m 2 was 14 times more likely to develop significant bacteriuria (AOR=14.44; 95%CI=3.55-58.77; p<0.01).…”

Identification of Bacterial Uropathogen and Antimicrobial Resistance Patterns Among Patients with Diabetic and Hypertension Attending Dilla University General Hospital, Dilla, Ethiopia

“…The sample size was calculated based on a single sample size estimation using the prevalence of 10.5% indicated in the study done in Ethiopia, 27 with an expected margin of error taken at 5% and a confidence interval of 95% and 10% contingency for the non-respondent. The calculated sample size was 158.…”