scholarly journals Bacterial Profile, Antimicrobial Susceptibility Pattern, and Associated Factors of Community- and Hospital-Acquired Urinary Tract Infection at Dessie Referral Hospital, Dessie, Northeast Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Berhanu Adugna ◽  
Bekele Sharew ◽  
Mohabaw Jemal

Background. Bacterial urinary tract infection is among the most common community and hospital-acquired infections. Therefore, to know the status of the community and hospital-acquired urinary tract infection, antimicrobial susceptibility patterns, and associated factors among urinary tract infection profiles are essential to physicians and health workers to implement appropriate intervention. Methods. An institution-based cross-sectional study was conducted among 422 urinary tract infection suspected patients. All isolates were identified by standard microbiological techniques, and their antibiotic susceptibility was done by the Kirby–Bauer disc diffusion method. Data were entered using EpiData version 3.1 and analyzed by SPSS software version 20. P value < 0.05 at 95% CI was considered statistically significant. Result. Of 422 urine samples processed, 100 (23.7%) yielded bacterial isolates. About 50(30.7%) and 50(19.3%) were bacterial isolates from the community and hospitalized patients, respectively. E. coli 44/103(42.7%) predominated across the two groups, followed by S. aureus 25/103(24.3%), CONs, 14/103(13.5%), Klebsiella spp. 7/103(6.78), Proteus spp. 3/103(2.91), and Enterococcus spp. 3/103 (2.91%). Pseudomonas spp. 3/103 (2.91), Citrobacter spp. 2/103(1.94%), and Acinetobacter spp. 1/103(0.999), which were isolated from only the hospitalized patients. Meropenem susceptibly was 100% in both study groups and Ampicillin resistance was documented as 83.3% to 100% and 76.9% to 100% in hospitalized and community-acquired samples, respectively. Conclusion. This study found a high prevalence of bacterial urinary tract infection in the study area and a high rate of bacterial resistance was observed to most antimicrobial drugs tested. Meropenem and nitrofurantoin were the most active drugs for urinary tract infections. Therefore, expanding routine bacterial culture and identification with antimicrobial susceptibility testing and strengthening regular surveillance systems are essential for appropriate patient care.

2021 ◽  
Author(s):  
Berhanu Adugna ◽  
Bekele Sharew ◽  
Mohabaw Jemal

Abstract Back ground: Urinary tract infection are one of the most common bacterial infections in the community and in the hospital. Nowadays, little is known about the status of community and hospital acquired urinary tract infection, antimicrobial susceptibility pattern and associated factors among urinary tract infection patients in Ethiopia, particularly in our study area. Methods A hospital based cross sectional study was carried out in Dessie referral hospital. A total of 422 urine samples were enrolled using systematic random sampling technique. All isolates were identified by standard microbiological techniques and their antibiotic susceptibility was done by Kirby Bauer disc diffusion method. Data was entered using Epi data version 3.1 and analyzed by SPSS software version 20. P- Value < 0.05 at 95% CI was considered as statistically significant. Result Of 422 urine samples processed 100 (23.7%) yielded bacterial isolates. About50(30.7%) and 50(19.3%) samples from hospitalized and community showed significant bacteriuria respectively. E. coli 44/103(42.7%), predominated across the two groups followed by S. aureus 25/103(24.3%), CONs,14/103(13.5%), Klebsiella spps 7/103(6.78), proteus spps 3/103(2.91), and Entrococcus spps 3/103 (2.91%). Pseudomonas spps 3/103 (2.91), Citrobacter spps 2/103(1.94%) and Acinetobacter Spp 1/103(0.999), which were isolated from only the hospitalized samples. Meropenem susceptibly was 100% in both study groups and Ampicillin resistance was documented as 83.3–100% and 76.9–100% in hospitalized and community acquired respectively. Among risk factors previous use of antibiotics, female gender, Age, Diabetics, catheterization were associated with the infection. Conclusion The present study revealed that slightly high prevalence of urinary tract infection. High antimicrobial resistance was observed to most antimicrobial drugs tested. Meropenem and Nitrofurantoin were the most active drugs for urinary tract infection. Empirical selection of antimicrobial agents should be based on antibiotic sensitivity pattern of uropathogens that prevalent in that area. Female sex, age, previous use of antibiotics, catheterization and diabetics were at risk of urinary tract infection.


Author(s):  
Dadi Marami ◽  
Senthilkumar Balakrishnan ◽  
Berhanu Seyoum

Urinary tract infection remains a major public health problem in developing countries, where there are limited health-care services. Its prevalence is fueled by human immunodeficiency virus (HIV) infection. The emergence of antimicrobial resistance is now widespread and poses a serious clinical threat. This study investigated the prevalence, antimicrobial susceptibility pattern of bacterial isolates, and associated factors of urinary tract infections among HIV-positive adult patients. A cross-sectional study was conducted among 350 randomly selected HIV-positive patients at Hiwot Fana Specialized University Hospital from February to March 2016. Data were collected using a structured questionnaire. Clean-catch midstream urine samples were collected aseptically and examined using the recommended culture methods. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion technique. Data were analyzed using Statistical Package for the Social Sciences version 21.0. The logistic regression models were used to explore the predictors of the outcome. A p value < 0.05 was considered statistically significant. The overall prevalence of urinary tract infection was 18% (95% CI: 15.34–22.63). Individuals with age 35–44 years (Adjusted odds ratio (AOR): 4.07; 95% CI: 1.09, 5.10), income less than 46.7 USD (AOR: 2.76; 95% CI: 1.15, 6.07), and a CD4+ count less than 200 cells/mm3 (AOR: 2.07; 95% CI: 1.15, 3.73) had higher odds of UTI. Escherichia coli (38.1%), Klebsiella pneumoniae (23.8%), and Staphylococcus aureus (11.1%) were the predominant causes of urinary tract infection. E. coli was resistant to ampicillin (95.8%), ceftazidime (95.8%), cotrimoxazole (95.8%), amoxicillin (91.7%), ceftriaxone (87.5%), and tetracycline (87.2%). Multidrug resistance was observed in 46% of the isolates. The prevalence of urinary tract infection in this study was high compared to the previous reports in Ethiopia. Age 35–44 years, income less than 46.7 USD, and a CD4+ count < 200 cells/mm3 increase the odds of urinary tract infection. The most common isolates were E. coli, K. pneumoniae, and S. aureus. Almost half of the isolates were multidrug resistant. Actions to help mitigate the further spread of resistance are urgently needed in the study area.


2020 ◽  
Vol 5 (1) ◽  
pp. 881-885
Author(s):  
Ruchee Manandhar ◽  
Bijendra Raj Raghubanshi ◽  
Moni Mahato ◽  
Sweekrity Neupane ◽  
Rajni Lama

Introduction: Urinary tract infection (UTI) is a microbial infection of the urinary system involving the urinary tract anywhere from kidney to urethra. It is one of the most common bacterial infections affecting men and women in developing countries with a high rate of morbidity and financial cost. Objectives: The objective of our study is to study the prevalence of UTI in patients attending KIST Medical College & Teaching Hospital (KISTMCTH), and determine the antimicrobial susceptibility pattern of bacteria thus isolated. Methodology: A total of 3742 urine samples from patients suspected of urinary tract infections presenting with the history and symptoms suggestive of urinary tract infection, attending various departments of KISTMCTH from April 2017 to April 2018 were studied. Isolates were identified by standard microbiological methods and tested for in vitro antibiotic susceptibility by modified Kirby-Bauer disc diffusion method. Results: Pathogenic bacteria were isolated from 646 out of 3742 urine samples (17.26%). Escherichia coli was the most common bacteria isolated (67.02%) followed by Klebsiella pneumoniae (14.5%). Other bacteria isolated were Enterococcus spp, Pseudomonas aeurigenosa, Klebsiella oxytoca, Proteus mirabilis, Satphylococcus aureus, Coagulase negative staphylococcus spp, Proteus vulgaris, Acinetobacter spp, Citrobacter freundii, Citrobacter diversus and Enterobacter spp. The isolated pathogenic bacterias were most resistant to Ampicillin (46.43%) and least resistant to Imipenem (6.03%). However, the first line antibiotic the bacterias were least resistant to was cefotaxime (7.12%). Conclusions: Marked resistance has been observed with commonly prescribed antibiotics like Ciprofloxacin and Norfloxacin. Therefore, studies should be conducted routinely to identify the common bacteria causing UTI and formulate appropriate antibiotic policy.


2020 ◽  
Vol 14 (3) ◽  
pp. 1
Author(s):  
Mardhia Mardhia ◽  
Mahyarudin Mahyarudin ◽  
Abror Irsan

Diabetic patients are associated with a higher risk of infection. The research purposed to identify antibiotic susceptibility patterns among diabetic outpatients with urinary tract infection in Pontianak. An experimental study was performed for 13 bacterial isolates of diabetic outpatients with urinary tract infection in the Clinic of Diabetes Mellitus, Sultan Syarif Mohamad Alkadrie Hospital, Pontianak. The disc diffusion method was used to perform the susceptibility of antibiotics to the bacterial isolates. Among 13 isolates, the most common causative agent of urinary tract infection was Escherichia coli (53.85%), followed by Pseudomonas aeruginosa (30.77%). Klebsiella spp and Enterobacter aerogenes were 7.69%. Most isolates of bacteria of the study had a high sensitivity to Cefepime (92.31%), then followed by Levofloxacin, Amikacin, and Meropenem for 84.62%. The study revealed low sensitivity of bacteria to Amoxicillin/Clavulanate, Co-Trimoxazole, Cefazoline and Ceftriaxone (30.77%, 23.08 %, 23.08%, 23.08%, respectively). All bacterial isolates had high resistance to Ampicillin. Moreover, multidrug resistance observed among bacterial isolates. Keywords: antibiotic susceptibility, diabetes, urinary tract infections


2021 ◽  
Vol 8 (2) ◽  
pp. 80-84
Author(s):  
Milind Davane ◽  
Sanjivani Mundhe

Background: Globally, urinary tract infection (UTI) is considered a major public health concern and the second most common bacterial infection affecting individuals of different ages worldwide. Urinary tract infections (UTIs) are caused by multiplicity of microorganisms. The chronicity of different bacterial isolates and their propensity to various antibiotics may differ widely, particularly in hospitalized patients, that makes the study of susceptibility pattern mandatory for a proper selection of antibiotics. Objective: To evaluate antimicrobial susceptibility pattern of the Gram negative organisms isolated from urine cultures of hospitalized patients. Material and Methods: A total of 500 urine samples from hospitalized patients which showed significant bacteriuria were studied. Samples were inoculated on Blood agar and MacConckey agar. Further identification and study of organisms was done by standard Microbiological methods. Antimicrobial Susceptibility pattern was studied by Modified Kirby- Bauer’s disc diffusion method with the panel of 15 drugs as per Clinical Laboratories Standard Institute (CLSI) guidelines. Results: UTIs were found more common in females 290 (58%). Commonest organism found was Escherichia coli 260 (52%) followed by Klebsiella spp. 120 (24%), Pseudomonas spp. 40 (8%), Proteus spp. 38 (7.6%), Citrobacter spp. 25 (5%) and Acinetobacter spp. 17 (3.4%). Majority of the strains were found sensitive to nitrofurantoin followed by amikacin, piperacillin-tazobactam and cotrimoxazole. Commonly prescribed fluroquinolones were found least effective for treatment of UTI. All the strains were found sensitive to imipenem. Extended spectrum beta lactamase (ESBL) was noted in E.coli and in Klebsiella spp. Conclusion: To discourage the indiscriminate use of antibiotics and to prevent further development of bacterial drug resistance, proper knowledge of susceptibility pattern of uropathogens in particular area is very important before prescribing any empirical antibiotic therapy.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guesh Gebremariam ◽  
Haftom Legese ◽  
Yemane Woldu ◽  
Tadele Araya ◽  
Kiflom Hagos ◽  
...  

Abstract Background Bacterial infection of the urinary tract is among the common reasons for seeking medical attention in the community. Rapidly increasing antibiotic resistance of uropathogens is resulting in limited treatment options. Therefore, knowledge of the current uropathogens and their antibiotic susceptibility is important for better treatment of urinary tract infection. Methods A cross-sectional study design was conducted from February to September thirty, 2017 among students who came to Mekelle University student’s clinics with symptomatic urinary tract infection during the study period.. Mid-stream urine specimens were collected from 341individuals with suspected urinary tract infection for bacteriological identification and antimicrobial susceptibility testing. Data on socio-demographic, clinical and risk factors were also collected using a structured questionnaire. Results Among the 341 study participants, 72(21.1%) showed significant bacteriuria. Escherichia coli (48.6%), Coagulase-negative staphylococci (23%), Staphylococcus aureus (13.5%), and Klebsiella spp. (8.1%) were common bacterial isolates. Resistance to ampicillin (81–100%), amoxicillin/clavulanic acid (77–93.6%), co- trimoxazole (55 72.3%), nalidixic acid (57.4%) and tetracycline (46–55.5%) was seen by most isolates. Multidrug resistance was observed in 73% of the bacterial isolates, and 25.5% of the Gram-negative isolates were extended-spectrum beta-lactamase producers. Being female, a history of urinary tract infection, a history of catheterization and frequent sexual activity were found to be statistically associated with urinary tract infection. Conclusion Urinary tract infection is a problem among university students with a prevalence of 21.1%. All isolates have developed resistance to most of the commonly used antibiotics. Therefore, health education on the transmission and causes of urinary tract infection are recommended for the students.


2018 ◽  
Vol 4 (2) ◽  
pp. 30-34 ◽  
Author(s):  
Surovi Era Suchi ◽  
SM Shamsuzzaman ◽  
Bhuiyan Mohammad Mahtab Uddin ◽  
Md Abdullah Yusuf

Background: The genus Enterococcus is of increasing significance as a cause of nosocomial infections and this trend is exacerbated by the development of antibiotic resistance.Objective: The aims of this study was to find out the susceptibility pattern and the prevalence of virulence genes in Enterococcus strains isolated from urinary tract infection in Bangladesh.Methodology: This cross-sectional study was conducted in the Department of Microbiology at Dhaka Medical College, Dhaka from January 2015 to December 2015 for a period of one (01) years. All the admitted patients in the Dhaka Medical College & Hospital, Dhaka and Banghabandhu Sheikh Mujib Medical University, Dhaka who were  presented with clinical features of urinary tract infection at any age with both sexes were included as study population. The antimicrobial susceptibility of the strains was determined using the disk diffusion method; vancomycin susceptibility pattern was detected by MIC method. PCR was performed for the detection of genus-species, vanA, vanB gene and potential virulence genes.Result: Out of 84 Enterococci, majority (71.42%) of the isolates were E. faecalis followed by 23.81% were E. faecium. Regarding antimicrobial susceptibility pattern, 100% isolated Enterococci were sensitive to vancomycin, linezolid and teicoplanin. Most of the Enterococci were resistant to ciprofloxacin and ceftriaxone (92.86%) followed by 88.10% to gentamicin and 85.71% to azithromycin and rifampicin. No VRE was identified and the range of MIC for vancomycin was 1-4 µg/ml. None of the Enterococci was positive for vanA and vanB genes. Out of total E. faecalis and E. faecium, 87.50% were positive for ebp and 77.5%, 72.5%, 55.0%, 45.0%, 40.0% and 10.0% of isolates were positive for gelE, esp, ace, cyl, asa and hyl respectively.Conclusion: Almost all the virulence genes were more prevalent in E. faecalis isolates.Bangladesh Journal of Infectious Diseases 2017;4(2):30-34


2010 ◽  
Vol 21 (3) ◽  
pp. 247-257 ◽  
Author(s):  
Mikel Gray

Changes in reimbursement policies have focused attention on the use of indwelling catheters in the critical care unit as well as their role in hospital-acquired urinary tract infections. Implementation of an evidence-based prevention program can significantly reduce both the prevalence of indwelling catheterization and the incidence of hospital-acquired catheter-associated urinary tract infection. This article describes the epidemiology and pathophysiology of catheter-associated urinary tract infection, and outlines essential elements of an evidence-based prevention program for the critical care unit.


2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Ibtesam Salih Abdulrahman

Urinary tract infections represents one of the most common diseases encountered in medical practice affecting people of all ages from the neonate to the geriatric age group. The aim of this study was to determine and evaluate the antimicrobial susceptibility patterns for most common strains of bacterial urine isolates taken from patients at Azadi teaching hospital laboratories in Duhok city/Kurdistan region in Iraq, for two years (2014 and 2015). A retrospective survey study was conducted and 1003 data of urine culture sensitivity test were collected from recorded archives of the Azadi hospital of two years; 2014 and 2015.  The study included all recorded positive urine samples cultures isolated from inpatients and outpatients. Results revealed that the female to male ratio for urinary tract infection was 2.7:1 and the most common microorganisms isolated were Escherichia coli (52%), Staphylococcus aureus (11%), Staphylococcus haemolyticus (9.6%) and Klebsiella pneumoniae (8.1%). In general maximum sensitivity was seen for Meropenem (94.9%), followed by Imipenem (89.7%) and Ertapenem (88.7%). The maximum resistance was seen against Cefazolin (79.7%) and Amoxicillin/clavulanic acid (77.5%). The antibiotic sensitivity pattern of E. coli reveals that the maximum sensitivity was seen for Meropenem (97.3%) and Imipenem (95.6%). The maximum resistance was seen against Amoxicillin/clavlanic acid (83.1%). The resistance against many commonly used antibiotics have been increased which limit the options for treating urinary tract infection. This is resulted from uncontrolled use of the antibiotics and lack of policies and guidelines for their use in public health. 


2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Shima Sadat Lesani ◽  
Mohammad Soleimani ◽  
Pegah Shakib ◽  
Mohammad Reza Zolfaghari

Background: Escherichia coli is considered as one of the causes of opportunistic infections. Nowadays, due to the increase in drug resistance, the treatment of these infections has become very difficult and they are recognized as the main causes of death in hospitalized patients. Objectives: The aim of this study was to determine the prevalence of blaTEM, blaSHV, and blaCTX-M genes in E. coli strains isolated from the urinary tract infection in patients in Intensive Care Units of three different hospitals in Qom, Iran. Methods: This study was conducted in three months from October to December 2014. A total of 200 E. coli samples were taken from the patients with urinary tract infections in Intensive Care units of Qom hospital. The disc diffusion method was used to determine the susceptibility pattern of antibiotic and phenotypic confirmatory tests for screening of the expanded spectrum beta-lactamase (ESBL) isolates. The presence of blaTEM, blaSHV, and blaCTX-M genes was evaluated by the polymerase chain reaction (PCR) assay. Results: Of 200 samples, ampicillin (96%) and nitrofurantoin (19.5%) showed the highest and lowest drug resistance, respectively. A total of 156 isolates (78%) were identified as ESBLs using the phenotypic method. Moreover, 76 (38%), 90 (45%), and 123 (61.5%) isolates consisted of blaCTX-M, blaSHV, and blaTEM, respectively. Conclusions: Overall, the findings of this study showed that blaTEM was the most common gene with a frequency of 61.5% in ESBL E. coli.


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