Epidemiology and Antimicrobial Susceptibility Pattern of Uropathogens in Patients with the Community- and Hospital-Acquired Urinary Tract Infections at a Tertiary Hospital in Somalia

Abstract

Background: Urinary tract infections (UTIs) are the most common infections in the community and in hospitalized patients. Objectives: To investigate the epidemiology and antimicrobial susceptibility pattern of uropathogens and determine the appropriate empirical antibiotics to treat UTIs in the community and hospitalized patients. Methods: A total of 2,485 urine cultures were performed at Mogadishu Somali Turkish Training and Research Hospital. Through the standard Kirby-Bauer disk diffusion method and commercial disks, antimicrobial sensitivity and resistance were studied based on the Clinical and Laboratory Standards Institute (CLSI) system using Mueller-Hinton agar. The identification of the microorganisms was done using eosin methylene blue agar and blood agar. Results: Escherichia coli was the most predominant pathogen (63.4%) in all age groups, both genders, and in the community and hospital-acquired UTIs, followed by Klebsiella pneumonia (13.3%). Ceftriaxone, trimethoprim/sulfamethoxazole, ampicillin, cefuroxime, and cefixime revealed the highest resistance level (82-100%) against uropathogens. Ciprofloxacin (67.7%) and levofloxacin (54.2%) showed increasing resistance rates against uropathogens. Tigecycline, colimycin, vancomycin, and teicoplanin exhibited the most powerful sensitivity rate (100%). Moreover, fosfomycin, nitrofurantoin, and amikacin manifested a significant sensitivity rate ranging from 86% - 95%. Acinetobacter baumannii was the most prevalent pathogen that belonged to multidrug- and extensively drug-resistant patterns in 69.1% of the samples. Escherichia coli and K. pneumonia showed similar multidrug-resistant patterns in 35.2% of the cases. Conclusions: The results indicated increased trends of antimicrobial resistance rate in trimethoprim/sulfamethoxazole (85.1%) and fluoroquinolones (61%) against E. coli that was higher than the recommended local resistance rate for empirical therapy (< 20% and < 10%, respectively). According to the results, using fosfomycin and nitrofurantoin are suggested for UTI empiric treatment, and other antibiotics should be prescribed carefully.

Distribution and Antimicrobial Susceptibility of Gram-Positive and Gram-Negative Pathogens Isolated from Patients Hospitalized in a Tertiary Teaching Hospital in Southwestern China

“…Our results showed that the species of the five domi-nant bacteria were consistent with those reported in studies in other regions, including the CHINET for China (5), Zhengzhou (China) (6), Nanjing (China) (26), Seoul (Korea) (27), Somalia (28), and Greece (21), but the proportions of the five dominant bacteria were different. Therefore, it was necessary to analyze the proportions of bacteria in different areas.…”

Antimicrobial Resistance and Predisposing Factors Associated with Catheter-Associated UTI Caused by Uropathogens Exhibiting Multidrug-Resistant Patterns: A 3-Year Retrospective Study at a Tertiary Hospital in Mogadishu, Somalia

“…The identification of the uropathogens was achieved by a combination of a BD BBL crystal identification system with a series of biochemical tests according to the system of the Clinical and Laboratory Standards Institute (CLSI). The growth of a single uropathogen with >100,000 CFU/mL represents CA-UTI [ 8 ]. The production of extended-spectrum beta-lactamases (ESBL) was identified from positive urine cultures using cephalosporins (ceftriaxone (30 µg), +cefotaxime (30 µg), +ceftazidime (30 µg)) and amoxicillin–clavulanic acid (20/10 µg) as the identifying disc to differentiate the patterns of growth between antibiotics with a lactamase inhibitor and those without.…”

“…Many studies have reported that numerous uropathogens are resistant to commonly used antibiotics, which challenges the treatment and empiric therapy of patients with CA-UTI with MDR microorganisms [ 7 ]. Despite the increasing concern relating to antimicrobial-resistant pathogens, the number of UTI patients is increasing swiftly, and the nature of the infection is diverse according to local and geographical locations [ 8 ].…”

Knowledge, attitude, and practice (KAP) regarding erectile dysfunction disease and its medications among community pharmacy technicians in Mogadishu Somalia

“…A retrospective study by Mohamed AH regarding epidemiological characteristics and predisposing factors for surgical site infections caused by bacterial pathogens exhibiting multidrug-resistant patterns, epidemiology and antimicrobial susceptibility pattern of uropathogens in patients with the community-and hospital-acquired urinary tract infections at a tertiary hospital in Somalia. It reported higher rates of antimicrobial resistance, multidrug-resistant (MDR), and extensively drug-resistant (XDR) pathogens owing to an improper prescription of antibiotics, epidemic misuse of antimicrobials, self-prescription of antibiotics, and the lack of knowledge about drug resistance [ 14 , 15 ]. This widespread misuse of medications and the availability of the PDE5Is in every community pharmacy in the country became a significant health threat and public health problem.…”