Microbiological profile and antimicrobial susceptibility pattern among patients with urinary tract infection in northern Tanzania

Halima Jasper  Mbwambo; Orgeness Jasper  Mbwambo; Frank Boniphas  Bright; Alfred Chacha  Charles; Kien Alfred  Mteta; Japer Said  Mbwambo; Bartholomeo Nicholaus  Ngowi

doi:10.30574/gscbps.2021.16.2.0226

Authors

Halima Jasper Mbwambo Department of urology, faculty of medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi Tanzania.
Orgeness Jasper Mbwambo Department of urology, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi Tanzania.
Frank Boniphas Bright Department of urology, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi Tanzania.
Alfred Chacha Charles Department of clinical laboratory, faculty of medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi Tanzania.
Kien Alfred Mteta Department of urology, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi Tanzania.
Japer Said Mbwambo Department of urology, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi Tanzania.
Bartholomeo Nicholaus Ngowi Department of urology, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi Tanzania.

DOI:

https://doi.org/10.30574/gscbps.2021.16.2.0226

Keywords:

Urinary tract infection, Kilimanjaro Christian Medical Center, Microbiological Profile, Antimicrobial susceptibility pattern

Abstract

Background: Urinary tract infection (UTI) is the most common bacterial infection, it causes morbidity as well as financial burden. There is a role of empirical treatment of UTI while awaiting urine culture and sensitivity result. The type of empirical antibiotics given varies from place to place depending on susceptibility pattern of the particular area. According to Tanzania standard treatment guidelines and essential medicine list of 2013, cystitis in adult is treated by ciprofloxacin while pregnant women and children are treated by amoxicillin/clavulanate. In case of pyelonephritis, women of reproductive age who does not require referral are treated by ciprofloxacin while all other cases that fulfill criteria for referral are given single dose of ceftriaxone before referral. However, most studies have shown increasing resistance to commonly used antibiotics as a result of misuse and overuse.

The study aimed at describing the microbiological profile and susceptibility pattern among patients with UTI at KCMC.

Methods: This was a seven-month hospital based descriptive, cross-sectional study conducted from June 2016 to December 2016 by using structured data extraction sheet. Data analysis was performed using SPSS after cleaning and checking for error(s).

Results: A total of 270 samples that tested positive for UTI were analyzed. Majority 233(86.3%) of the sample were obtained from male subjects, age of study subjects ranged from 1-94 years with the median of 64 years. Majority 235 (87%) of the sample came from urology department with E. coli being most common cause of UTI (39.3%), followed by Klebsiella spp, 20%. E. coli demonstrated high sensitivity against amikacin, ceftazidime and Nitrofurantoin

Conclusion: The commonest cause of UTI in our set up is E. coli that showed high resistance against most commonly used antibiotics in our setting.

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References

Fasugba O, Gardner A, Mitchell BG, Mnatzaganian G. Ciprofloxacin resistance in community and hospital-acquired Escherichia coli urinary tract infections. BMC Infectious Diseases. 2015; 1-16.

Pobiega M, Wojkowska-Mach J, Maciag J, Chmielarczyk A, Romaniszyn D, Pomorska-Wosolowska M et al. Virulence and Antibiotic Resistance of Pseudomonas aeruginosa Isolated from Patients with Urinary Tract Infections in Southern Poland. Chemotherapy. 2014; 253-260.

Zowawi HM, Harris PN, Roberts MJ, Tambyah PA, Schembri MA, Pezzani MD et al.The emerging threat of multidrug-resistant Gram-negative bacteria in urology. Nature Reviews Urology. 2015; 12(10): 570–584.

Mohan DG, Sarmah A, Hazarika NK. A study on microbiological profile of complicated Urinary Tract Infection (UTI ) in a tertiary care hospital of NE region. International Journal of Medical and Health Research. 2016; 2(1): 47–50.

Linhares I, Raposo T, Rodrigues A, Almeida A. ‘Incidence and Diversity of Antimicrobial Multidrug Resistance Profiles of Uropathogenic Bacteria. BioMed Research International. 2015; 1-11.

Walker BR, Colledge NR, Ralston SH, Penman ID. Davidson's Principles & Practice of Medicine. 22nd Edition. Edinburgh:Churchill Livingstone. 2021.

Wagenlehner Fm, Weidner W, Naber Kg. Emergence Of Antibiotic Resistance Amongst Hospital-Acquired Urinary Tract Infections And Pharmacokinetic/Pharmacodynamic Considerations. J Hosp Infect. Jul 2005; 60(3): 191-200.

Ministry of health and social welfare of Tanzania. Standard Treatment Guidelines and the National Essential Medicine List [internet]. May 2013.

WHO. WHO’s first global report on antibiotic resistance reveals serious, worldwide threat to public health. 2014.

Al-Benwan K, Al-Sweih N, Rotimi VO. Etiology and Antibiotic Susceptibility Patterns of Community- and Hospital-Acquired Urinary Tract Infections in a General Hospital in Kuwait. Medical Principles and Practice. 2010; 19(6): 440–6.

Kalal B, Nagaraj S. Urinary tract infections: a retrospective, descriptive study of causative organisms and antimicrobial pattern of samples received for culture, from a tertiary care setting. GERMS. Dec 2016; 6(4): 132–138.

Abejew AA, Denboba AA, Mekonnen AG. Prevalence and antibiotic resistance pattern of urinary tract bacterial infections in Dessie area, North-East Ethiopia. BMC research notes. December 2014; 1-7.

Fredrick F, Francis JM, Fataki M, Maselle SY. Aetiology, antimicrobial susceptibility and predictors of urinary tract infection among febrile under-fives at Muhimbili National Hospital, Dar es Salaam-Tanzania. African Journal of Microbiology Research. 2013; 7(12): 1029-34.

Linsenmeyer K, Strymish J. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections. Antimicrobial Agents and Chemotherapy. Dec 2015; 59(12): 7593–96.

Moyo SJ, Aboud S, Kasubi M, Lyamuya EF, Maselle SY. Antimicrobial resistance among producers and non-producers of extended spectrum betalactamases in urinary isolates at a tertiary Hospital in Tanzania. BMC Research Notes. 2010; 1-5.

Bours PHA, Polak R, Hoepelman AIM, Delgado E, Jarquin A, Matute AJ. Increasing resistance in community-acquired urinary tract infections in Latin America, five years after the implementation of national therapeutic guidelines. international journal of infectious disease. September 2010; 14(9): 770-74.

Pourakbari B, Ferdosian F, Mahmoudi S, Mostafa Teymuri M, Sabouni F, Heydari H et all. Increase resistant rates and ESBL production between E. coli isolates causing urinary tract infection in young patients from Iran. Braz J Microbiol. Apr-Jun 2012; 43(2): 766-69.

Kyabaggu D, Ejobi F, Olila D. The sensitivities to first-line antibiotic therapy of the common urinary tract bacterial infections detected in urine samples at a hospital in metropolitan Kampala (Uganda). Afr Health Sci. Dec 2007; 7(4): 214–22.

Somashekara SC, Deepalaxmi S, Jagannath N, Ramesh B, Laveesh MR, Govindadas D. Retrospective analysis of antibiotic resistance pattern to urinary pathogens in a Tertiary Care Hospital in South. Journal of Basic and Clinical Pharmacy. 2014; 5(4): 105–8.

Coppo E, Barbieri R, Bottaro LC, Illiberi O, Piazzai P, Debbia E A et al. Local survelance study on etiology of community-and hospital-acquired urinary tract infections (UTI) and antimicrobial susceptibility of uropathogens. Microbiologia Medica. 2012; 27(1): 17–19.