Bacteriuria, Candiduria And Antimicrobial Resistance Patterns Among Hemodialysis Patients at Selected Dialysis Centers, Addis Ababa, Ethiopia
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Date
2017-06
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Addis Ababa University
Abstract
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
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Keywords
Bacteria, Candida, Antimicrobial resistance, Hemodialysis