Antibiotic resistance pattern of Escherichia coli isolates from outpatients with urinary tract infections in Somalia

Abstract

Introduction: Several studies suggest increasing rates of antibiotic resistance among adult populations with Urinary tract infections (UTI). Escherichia coli (E. coli), is the predominant bacterium both in the community and in hospital environments causing uropathogenic infections. This study aimed to estimate the common uropathogen bacteria that cause UTI among outpatients as well as to determine the antibiotic resistance pattern of E. coli isolates among outpatients with UTI infections at Shaafi hospital, Mogadishu, Somalia.
 Methodology: A cross-sectional study was conducted at Shaafi Hospital, Mogadishu, Somalia. A total of 128 samples were collected from outpatients suspected of UTI and tested through bacteriological investigations and antimicrobial susceptibility tests following the Kirby-Bauer agar disc diffusion method.
 Results: E. coli was isolated in 34 (41%) out of the total 83 samples that showed growth followed by Staphylococcus aureus 22 (26.5%), Pseudomonas aeruginosa, 13 (15.7%), Klebsiella pneumoniae 8 (9.6 %) and Proteus spp. 6 (7.2%). E. coli was highly sensitive to nitrofurantoin, 29 (85.3%), and ciprofloxacin (n = 23, 67.6%), and had the highest resistance rate of ceftriaxone, 33 (97.1%). The odds of having UTI were higher in patients with a history of UTI (Odds ratio OR = 0.211, 95% confidence interval CI: 0.080, 0.553) and history of antibiotic use (OR = 0.322, 95% CI: 0.113, 0.917). Increased resistance rate of E. coli against cephalosporins could be due to its excessive use as empirical therapy.
 Conclusion: The study indicates that outpatients with UTI could be at high risk of antibiotic resistance, suggesting regular surveillance and monitoring of antibiotics.

Relationship Between Antibiotic Resistance Patterns and O-Serogroups in Uropathogenic Escherichia coli Strains Isolated from Iraqi Patients

“…In general, the penicillins and cephalosporins are not active against UTIs in developing countries, such as Iraq; therefore, according to the results, such antibiotics should not be used in the treatment of UTIs. In recent years, quinolones, es-pecially ciprofloxacin, have been used to treat E. coli infections, and studies in different parts of the world have shown that quinolones are still active against UTIs (23,24). However, 27% of the UPEC isolates in the present study showed resistance to ciprofloxacin.…”

Occurrence and Phenotypic Characterization of Multidrug-Resistant Bacterial Pathogens Isolated from Patients in a Public Hospital in Mogadishu, Somalia

“… 17 , 18 Previous studies in Iran, Sudan, and Somalia have all reported a high rate of bacterial contamination among patients under hospitalization, which conforms with the result of the present study. 12 , 13 , 19 In each of the aforementioned reports, the poor healthcare delivery services, and poverty may have played a role in the high rate of bacterial isolation observed.…”

“…The sample size was determined using the 26.5% prevalence of Staphylococcus aureus reported by Mohammed et al among outpatients with urinary tract infections in Somalia. 13 …”

“…Although some investigations have been conducted on antimicrobial resistance among Escherichia coli in outpatients with urinary tract infections, as well as Staphylococcus aureus isolated from patients with skin wound infection, the present investigation was undertaken with a wider purview. 12 , 13 The study was set out to investigate the prevalence of multidrug-resistant pathogenic bacterial organisms from clinical samples collected from a public hospital in Mogadishu, Somalia, during a five months period. The samples (vaginal swabs, blood, stool, and urine) were collected from the patients under hospitalization, and the phenotypic characterization of drug resistance among the positive isolates was undertaken.…”

Resistência aos antibióticos de uso oral a partir de isolados de urina de pacientes não hospitalizados

“…1,2 Isso ocorreu, também, devido ao uso descontrolado e indevido de antibióticos 3 , além disso, pacientes não hospitalizados com infecção urinária têm apresentado alto risco em desenvolver resistência aos antibióticos. 4 Como consequência da RAM, muitos dos medicamentos geralmente utilizados na terapêutica não apresentam eficácia e as infecções permanecem no hospedeiro tendendo a uma ameaça de proliferação. 5 O uso indiscriminado dos antimicrobianos amplia a pressão seletiva e beneficia o progresso da resistência, pois muitos pacientes acabam se automedicando além de não cumprir com o tratamento corretamente.…”