Bacterial and Fungal profile, antibacterial drug susceptibility pattern, and associated factors of isolates recovered from kidney transplant recipients' urine samples at Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia.
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Date
2021-09
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Addis Abeba University
Abstract
Background: Urinary tract infections (UTIs) are the most infections in renal transplant
recipients and it has serious consequences in several countries including Ethiopia.
Objective: To determine the bacterial and fungal profile, antibacterial drug susceptibility
patterns and risk factors for urinary tract infections caused by bacteria and fungal etiological
agents from urine of kidney transplanted patients at SPHMMC Addis Ababa, Ethiopia.
Method: A hospital-based cross-sectional study was conducted from November 2020 to April
2021. A structured questionnaire was used to collect data on socio-demographic factors and
clinical conditions. Blood, MacConkey, and brain heart infusion agar were used to culture all
urine samples. Gram stain, biochemical tests, and chromagar for yeast were used to characterize
all culture positives were done according to the standard technique. All bacterial isolates were
tested for antibiotic susceptibility using the Kirby-Bauer method. The possible risk factors were
assessed using simple and multivariate logistic regressions.
Results: 63 pathogenic microorganisms were found in 207 clinical specimens. Gram negative
bacteria accounted for 63.5 %, Gram positive bacteria for 23.8% and fungal isolates represented
12.69 %. The most common bacteria identified in urinary tract infections (UTIs) were E. coli,
Klebsiella pneumoniae, and Coagulase negative staphylococcus. Candidia krusei and Candidia
albicans was among fungal isolates. Multidrug resistances were observed among 82% of Gramnegative
bacteria. The highest rates of antimicrobial resistance were observed in
Aminoglycosides and 3rd generation cephalosporins. Carbapenem, Nitrofurantoin, Nalidixic
acid, Amikacin and Fluoroquinolones were the most effective antibiotic to treat UTIs.
Conclusion: Candidia albicans and Candidia krusie funguria were shown to be prevalent UTIs
in people who had their kidneys transplanted, according to the study. Bacterial isolates showed
resistance to commonly used antibiotics. These data are essential for identifying future potential
prevention strategies against UTI in kidney transplant recipients, as well as the causal agent,
related factor and antibiotic resistance pattern.
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Keywords
Urinary tract infection, Bacterial and fungal profile, Antibacterial susceptibility patterns, Risk factor Addis Ababa, Ethiopia.