Bacterial Urinary Tract Infection Among Adult Renal Transplant Recipients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Date
2019-04
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Addis Ababa University
Abstract
Background: Although significant advances have been made in surgical techniques and immunosuppression for renal transplantation, urinary tract infections continue to be a major public health problem globally. Post transplantation urinary tract infection complications including asymptomatic bacteriuria, cystitis, and pyelonephritis are the most common form of bacterial
infection following renal transplantation. It could result in graft function impairment and death.
Objectives: The study aimed to investigate the prevalence of bacterial isolates that cause urinary tract infections, assess antibiotic susceptibility pattern among symptomatic and asymptomatic renal transplant recipients attending for health care at St. Paul’s Hospital Millennium Medical College.
Materials and Methods: A hospital-based cross-sectional study was carried out from December 2017 to August 2018 among 74 renal transplant recipients. The sociodemographic characteristics were collected using structured questionnaires. A first morning voided clean-catch mid-stream urine specimens were collected and 0.001ml inoculated onto a blood and MacConkey agar plates following the standard bacteriological protocols. It was incubated aerobically at 35–37°C for 18–24 hours. Cultural characteristics and series of biochemical tests were used for identification.
Results: Significant bacteriuria was found in 11/74 (14.9%), 95%CI =8.2-24.7) of the patients. The prevalence among females 6/32(18.75%) was higher than males 5/42(11.9%) without significant association (COR=2.09, 95%CI=1.04-8.45, P=0.253). UTI was higher in the age group between 35–49 years old (19.3%. Age was statistically significant and stronger independent associated risk factor with crude odds ratio=3.67, 95%CI=2.89-20.07 and 0.003, respectively. The most prevalent bacteria isolates were Escherichia coli 2(18.2%), Staphylococcus aureus 2(18.2%), Acinetobacter spp. 2(18.2%), Enterococcus spp. 2(18.2%), Coagulase-negative Staphylococci 2(18.2%)] followed by Portus mirabilis 1(9.1%).The majority (80%) of Gram-negative bacteria were resistant to ciprofloxacin, chloramphenicol, and trimethoprim /sulfamethoxazole. Multi drug resistance pattern was shown in 82% of the isolates.
Conclusion and Recommendations: The overall prevalence of UTI in the study was low with a prevalence of 14.9%. Better to establish routine urine cultures especially in the first 6-12 months.
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Kidney Transplantation, Urinary Tract Infection, Urine Culture, Antimicrobial Susceptibility Testing, St. Paul’s Hospital Millennium Medical College.