The Prevalence of Bacterial Urinary Tract Infection and Antimicrobial Resistance Patterns of Bacterial Uropathogens Among Diabetes Mellitus Patients at Zewditu Memorial Hospital in Addis Ababa, Ethiopia
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Date
2019-07
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Addis Ababa University
Abstract
Background: Urinary tract infection is caused by colonization and growth of microorganisms such as bacteria, fungi and viruses within genito-urinary system. Most of these infections are acquired through ascending routes from the nearby anal opening. Due to impaired host defense and high glucose concentration in urine, diabetic patients are more prone to bacterial urinary
tract infections than non- diabetics patients.
Objective: This study was conducted to determine the prevalence of bacterial urinary tract infection, along with associated factors and antimicrobial resistance patterns of bacterial uropathogens among diabetes patients.
Methodology: Hospital-based cross sectional study was conducted between May and July 2018 at Zewditu Memorial Hospital in Addis Ababa, Ethiopia. Two handred twenty-five mid-stream urine samples collected for culture were inoculated in to Blood and MacConkey agar. Culture results showing significant growth were further tested for biochemical and antibiotic sensitivity.
Results: 150 (66.7%)females and 75 (33.3%)males with age ranges between 20 and 80 years were enrolled in this study. The overall prevalence of significant bacteriuria was 9.8%. Five species of bacterial uropathogens were isolated. Among these, E.coli (63.6%)was the leading causes of significant bacteriuria followed by K.pneumoniae (13.6%). in bivariate logestic regression analysis significant bacteriuria was strongly associated with duration of diabetics, previous urinary tract infections and symptomatic of urinary tract infection. In this study, neither gram-negative nor gram-positive bacteria were resistant to nitrofurantoin. In addition, all isolated gram-negative bacterial uropathogens were 100% sensitive to meropenem. In contrast, all gramnegative bacterial isolates were 100% resistant to ampicillin, doxycycline and cefuroxime. On the other hand, gram-positive bacteria were less resistant against tested antimicrobials
Conclusion and Recommendation: Presence of previous urinary tract infection and duration of diabetes were found as important associated factors that enhance urinary tract infection among diabetes patients. This study also showed high prevalence of drug resistant against common antimicrobials, particularly to co-trimoxazole, ciprofloxacin, doxycycline, ampicillin, augmentin, cefuroxime and penicillin suggesting the need for cautious use of antibiotic therapy for urinary tract infections. Therefore, Therapeutic selection for empirical treatment and management should be based on the knowledge of the local bacterial profile and antimicriobial response.
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Significant bacteriuria, antibiotic sensitivity, diabetis mellitus, associated factors