Bacteriuria, Candiduria And Antimicrobial Resistance Patterns Among Hemodialysis Patients at Selected Dialysis Centers, Addis Ababa, Ethiopia

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Addis Ababa University


Background: Hemodialysis patients are uniquely vulnerable for urinary tract infections at rates of 3 to 4 times than the general population. It is mostly associated with increased rate of complications due to often subclinical presentations and it is an important cause of morbidity and mortality among this group of patients. Objective: To determine the prevalence of bacteriuria, candiduria and antimicrobial resistance pattern among hemodialysis patients at selected dialysis centers, Addis Ababa, Ethiopia. Method: A cross sectional study was conducted from January to May 2017 at selected dialysis centers, Addis Ababa, Ethiopia. A total of 222 hemodialysis patients were included. Urine samples were collected and cultured on Blood agar and MacConkey agar for bacterial and on Sabroud dextrose agar for Candida ssp. isolation. All culture positive samples were characterized by colony morphology, gram stain and biochemical tests using the standard procedure. Candida spp. was identified by germ tube technique. Antimicrobial susceptibility testing was performed for bacterial isolates using Kirby-Bauer method. Data was analyzed using SPSS version 20. Result: The overall prevalence bacteria was 27.5% (n=61/222) and the predominant bacteria isolated were E coli 37.7% (n=23/61) and K. oxytoca 23% (n=14/61). S. aureus 4.9% (n=3/61) was the only gram positive isolate. The prevalence of candiduria was 2.7% (n=6/222) in which Candida albicans accounted 66.7% (n=4/6) while non- albicans were 33.3% (n=2/6). Multidrug resistance level was recorded 100% (n=61/61) for both Gram positive and Gram negative bacteria. Gram negative isolates were highly resistant to Ampicillin (88.5%), amoxicillin- clavulanic (82%) and chloramphenicol (82%). All isolated S. aureus were methicillin resistant. Conclusion: Assessing hemodialysis patients for bacterial UTIs at regular period is necessary for minimizing the possible occurrence of morbidity and/or mortality due to the infections. Isolations of Candida species from hemodialysis patients were significant in number. The possible choices of antibiotic options for treatment of urinary tract infections are few due to wide scale resistance to commonly used antibiotics. To prevent further emergence and spread of MDR bacteria rational use of antibiotics and regular monitoring of antimicrobial resistance patterns is essential. Key terms: Bacteria, Candida, antimicrobial resistance, hemodialysis, Addis Ababa, Ethiopia



Bacteria, Candida, Antimicrobial resistance, Hemodialysis