Microbiology of Urinary Tract Infections in Gaborone, Botswana

Abstract

ObjectiveThe microbiology and epidemiology of UTI pathogens are largely unknown in Botswana, a high prevalence HIV setting. Using laboratory data from the largest referral hospital and a private hospital, we describe the major pathogens causing UTI and their antimicrobial resistance patterns.MethodsThis retrospective study examined antimicrobial susceptibility data for urine samples collected at Princess Marina Hospital (PMH), Bokamoso Private Hospital (BPH), or one of their affiliated outpatient clinics. A urine sample was included in our dataset if it demonstrated pure growth of a single organism and accompanying antimicrobial susceptibility and subject demographic data were available.ResultsA total of 744 samples were included. Greater than 10% resistance was observed for amoxicillin, co-trimoxazole, amoxicillin-clavulanate, and ciprofloxacin. Resistance of E. coli isolates to ampicillin and co-trimoxazole was greater than 60% in all settings. HIV status did not significantly impact the microbiology of UTIs, but did impact antimicrobial resistance to co-trimoxazole.ConclusionsData suggests that antimicrobial resistance has already emerged to most oral antibiotics, making empiric management of outpatient UTIs challenging. Ampicillin, co-trimoxazole, and ciprofloxacin should not be used as empiric treatment for UTI in this context. Nitrofurantoin could be used for simple cystitis; aminoglycosides for uncomplicated UTI in inpatients.

Antibacterial Activity of Fosfomycin against Uropathogens

“…We collected 433 bacterial strains from cases of UTI in inpatients. The resistance rate at our hospital is similar to that reported in domestic research [18] and is higher than that found reported abroad [19,20]. In our study, the resistance rates for quinolones and cotrimoxazole, which are commonly used in UTI, were higher than 40%, except for Enterobacter cloacae .…”

Understanding the patterns of antibiotic susceptibility of bacteria causing urinary tract infection in West Bengal, India

“…(Francesco et al, 2007; Pires et al, 2007; den Heijer et al, 2012; Mukherjee et al, 2013; Prakash and Saxena, 2013; Renuart et al, 2013). Extended spectrum β-lactamase (ESbL)–producing organisms causing a significant increase in infection outbreaks have been reported in every continent around the world.…”

FROM WHENCE THEY CAME—ANTIBIOTIC-RESISTANTESCHERICHIA COLIIN AFRICAN WILDLIFE

“…Primary health care is available in the region; antibiotics can be acquired freely over the counter and resistance to many first-line antimicrobials is common (Rowe et al 2010;Pesapane et al 2013;Renuart et al 2013). There are no commercial livestock or poultry production operations in the region.…”