Bacterial Profile, Antimicrobial Resistance Patterns and the Associated Risk factors among Cancer Patients Suspected with Urinary Tract Infection in Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia.
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Date
2021-08
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Addis Abeba University
Abstract
Background: Bacterial infection is one of the most common life-threatening complications of
cancer and cancer treatment. Ureteral tract infection (UTI) has become a serious concern in
cancer patients. Therefore, the present study aimed to determine the spectrum and antibiotic
resistance pattern of bacteria related to urinary tract infections among cancer patients.
Objective: The study aimed to determine antimicrobial resistance pattern, UTI bacterial profile,
and their associated risk factors among cancer patients attending Tikur Anbesa Hospital, Addis
Ababa, Ethiopia.
Methods: A cross-sectional study was conducted from December 2020 to May 2021 among UTI
suspected cancer patients in Tikur Anbesa hospital. Study participants were recruited through a
convenient sampling technique through consecutive sampling. Socio-demographic variables
were collected using a pre-tested questioner while clinical variables were collected through chart
review and physical examinations. A morning midstream urine sample was collected for urine
culture. Colony characterization and species identification, and antimicrobial susceptibility were
carried out. The data was entered and analyzed using SPSS. Descriptive statistics were presented
using tables and figures. Bivariable and multivariable logistic regression analysis was done to
assess the association between dependent and independent variables. A P-value less than 0.05
was considered statistically significant.
Result: Of the total of 272 urine sample tested , about 20.2% of the study participants were
culture positive for a different type of bacterial pathogens predominantly gram-negative
pathogens outnumber 45 (81.8%). E. coli was the predominant one reported among 26 (47.3%)
of the patients followed K. pneumonia 9 (16.4%), Enterococcus Spp. 5 (9.1%). Majority of the
isolates were sensitive for gentamycin 69.1%, meropenem 95.6%, nitrofatonin 84%. Incontrast,
isolates were resistant to ciprofloxacin 90.7%, augmentin 88.9%, and ampicillin 96.4 %. Factors
such as being female (AOR 7.86, 95% CI (3.45, 17.89)), the presence of additional comorbidity
(AOR 2.4, 95% CI (1.05, 5.49)), those who had a history of catheterization (AOR 3.61, 95% CI
(1.04, 12.52)) and symptomatic cancer patients (AOR 3.79 95% CI(1.84, 7.79)) had statistical
significant association with more likely to develop bacteriuria
Conclusion and Recommendations: Bacteriuria among cancer patients was considerably high.
Being female, having a history of catheterization, presence of additional comorbidities, and
being symptomatic have been associated with bacteriuria. E. coli was the predominant bacterial
isolate. Antimicrobial susceptibility patterns showed that the majority of the isolates were
resistant to commonly used antibiotics such as ciprofloxacin, augmentin, and ampicillin. Thus,
urine culture is very important for cancer patients to control drug resistance, to restrict and give
only after doing culture and sensitivity tests.
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Keywords
UTI; Cancer patient; Bacterial profile; Antimicrobial resistance