Antibiotics Susceptibility Patterns of Uropathogenic Bacteria Isolates among Patients with Community-Acquired Urinary Tract Infections, Kanifing General Hospital, The Gambia 2021
- Anti-microbial resistance
Background
Urinary tract infections (UTI) are among the common infections encountered in healthcare facilities, affecting about 150 million people worldwide. In the Gambia, about 9% uropathogenic bacteria is reported among patients, with an increasing antibiotic resistance. This poses a public health threat for the treatment of community-acquired urinary tract infection (CA-UTI). This study determined the prevalence and factors associated with antibiotic susceptibility patterns of uropathogenic bacteria isolated from patients with CA-UTI at Kanifing General Hospital (KGH), The Gambia.
Methods
An analytic cross-sectional study was conducted from March-May, 2021 among outpatients who were not on antibiotics treatment and were clinically suspected of UTIs at KGH. Socio-demographic and risk factor (inappropriate antibiotic use, history of UTI and diabetes etc) variables were collected using a structured questionnaire. Urine samples of participants were collected aseptically for culture and antimicrobial susceptibility testing. We estimated proportions and odds ratios to determine factors associated with UTIs at 95% confidence level.
Results
Overall 422 patients, mostly females 82.5%(348/422) participated in the study. The prevalence of CA-UTI was 12.8%(54/422) with females constituting 94.4%(51/54). Escherichia coli was the most prevalent isolate 74.1%(40/54), followed by Klebsiella spp 18.5%(10/54). Resistance was highest to Ampicillin 87.0%(47/54), Trimethoprim/Sulfamethoxazole 77.8% (42/54) and Tetracycline 75.9%(41/54) antibiotics. About 87%(47/54) were Multi-Drug Resistance (MDR). Uropathogens sensitivity was 77.8%(42/54) to Nitrofurantoin and 75.9%(41/54) to Ceftazidime. Being female (aOR 6.9, CI=1.7-28.0), history of UTI (aOR 2.6, CI=1.05-6.16,), purchasing antibiotic from street vendor or local pharmacy (aOR 2.0, CI=1.07-3.74) and having no formal education (aOR 8.6, CI=1.1-67.1) were significantly associated to having uropathogenic bacterial isolates.
Conclusion
Escherichia coli was the most prevalent bacteria and mostly identified among females. Females, no formal education and inappropriate antibiotic usage were associated factors. Continuous AMR surveillance and monitoring are required to update clinical protocol of UTI
management. We recommended community health education to reduce inappropriate use of antimicrobials.
Urinary tract infections (UTI) are among the common infections encountered in healthcare facilities, affecting about 150 million people worldwide. In the Gambia, about 9% uropathogenic bacteria is reported among patients, with an increasing antibiotic resistance. This poses a public health threat for the treatment of community-acquired urinary tract infection (CA-UTI). This study determined the prevalence and factors associated with antibiotic susceptibility patterns of uropathogenic bacteria isolated from patients with CA-UTI at Kanifing General Hospital (KGH), The Gambia.
Methods
An analytic cross-sectional study was conducted from March-May, 2021 among outpatients who were not on antibiotics treatment and were clinically suspected of UTIs at KGH. Socio-demographic and risk factor (inappropriate antibiotic use, history of UTI and diabetes etc) variables were collected using a structured questionnaire. Urine samples of participants were collected aseptically for culture and antimicrobial susceptibility testing. We estimated proportions and odds ratios to determine factors associated with UTIs at 95% confidence level.
Results
Overall 422 patients, mostly females 82.5%(348/422) participated in the study. The prevalence of CA-UTI was 12.8%(54/422) with females constituting 94.4%(51/54). Escherichia coli was the most prevalent isolate 74.1%(40/54), followed by Klebsiella spp 18.5%(10/54). Resistance was highest to Ampicillin 87.0%(47/54), Trimethoprim/Sulfamethoxazole 77.8% (42/54) and Tetracycline 75.9%(41/54) antibiotics. About 87%(47/54) were Multi-Drug Resistance (MDR). Uropathogens sensitivity was 77.8%(42/54) to Nitrofurantoin and 75.9%(41/54) to Ceftazidime. Being female (aOR 6.9, CI=1.7-28.0), history of UTI (aOR 2.6, CI=1.05-6.16,), purchasing antibiotic from street vendor or local pharmacy (aOR 2.0, CI=1.07-3.74) and having no formal education (aOR 8.6, CI=1.1-67.1) were significantly associated to having uropathogenic bacterial isolates.
Conclusion
Escherichia coli was the most prevalent bacteria and mostly identified among females. Females, no formal education and inappropriate antibiotic usage were associated factors. Continuous AMR surveillance and monitoring are required to update clinical protocol of UTI
management. We recommended community health education to reduce inappropriate use of antimicrobials.