Prevalence and Antimicrobial Sensitivity Patterns of Uropathogens, in Tikur Anbessa Specialized Hospital Emergency Medicine Department Addis Ababa, Ethiopia

Abstract

Background Empirical treatment of infections remains a major contributing factor to the emergence of pathogens that are resistant to antibiotics. The study aimed to assess the prevalence and anti-microbial sensitivity patterns of uropathogens in the Emergency Medicine Department of Tikur Anbessa Hospital, Ethiopia. Methods Urine sample data collected over two years from January 2015 to January 2016 at Tikur Anbessa Hospital’s laboratory were retrospectively analyzed for bacterial pathogens, and their antimicrobial susceptibility. Antimicrobial sensitivity tests were done using the disc diffusion technique as per the standard of the Kirby-Bauer method. Results Of the total 220 samples that were collected, 50 (22.7%) were culture-positive. Male to female data ratio was 1:1.1. Escherichia coli was the dominant isolate (50%) followed by Enterococcus species (12%), Enterobacter species (12%), and Klebsiella species (8%). Overall resistance rates to Cotrimoxazole, Ampicillin, Augmentin, and Ceftriaxone were 90.4%, 88.8%, 82.5%, and 79.3%, respectively. The sensitivity rates for Chloramphenicol, Amikacin, Vancomycin, Meropenem, Cefoxitin, and Nitrofurantoin ranged from 72% to 100%. The antibiogram of isolates showed that 43 (86%) isolates were resistant to two or more antimicrobials, and 49 (98%) were resistant to at least one antibiotic. Conclusion and Recommendation Urinary tract infections are mostly caused by Gram-negative bacteria predominantly in females and Escherichia coli are the most common isolates. Resistance rates to Cotrimoxazole, Ampicillin, Augmentin, and Ceftriaxone were high. Chloramphenicol, Amikacin, Vancomycin, Meropenem, Cefoxitin, and Nitrofurantoin are considered appropriate antimicrobials for the empirical treatment of complicated urinary tract infections in the emergency department. Yet, using antibiotics indiscriminately for patients with complicated UTIs may increase the resistance rate and also lead to treatment failure, hence the prescriptions should be revised following the culture and sensitivity results.

Prevalence and Antimicrobial Sensitivity Patterns of Uropathogens in Wad Medani, Sudan: A Three Years, Cross-Sectional Study

“…21 Moreover, a study conducted in Addis Ababa, Ethiopia, reported that GNB were responsible for 84% of UTIs. 1 Overall, in the present study, S. aureus was the most frequently isolated bacteria, followed by E. coli. The prevalence of these bacteria among UTI patients may not be surprising, given that S. aureus is found within the skin's normal flora;…”

“…Urinary tract infections (UTIs) are one of the most prevalent infections caused by bacteria and can be detected in both community and healthcare settings. 1 UTIs exert a significant negative impact on an individual's quality of life and cause significant economic and public health burdens. 2 UTIs are a major cause of morbidity in older men and women of all ages and even in infant boys.…”

“…4,5 Antimicrobial resistance (AMR) is a challenge that impacts all countries, regardless of their financial standing or developmental level. 1 In particular, AMR is more severe in developing countries due to irrational antibiotic use and inadequate infection prevention strategies. 6 The AMR Global World Health Organization (WHO) report on surveillance states that Africa and Southeast Asia are the areas without functioning AMR surveillance systems.…”

Nitrofuran Derivatives Cross-Resistance Evidence—Uropathogenic Escherichia coli Nitrofurantoin and Furazidin In Vitro Susceptibility Testing

“… Overview of data on Escherichia coli urine isolates nitrofurantoin resistance in the 21st century worldwide reports [ 2 , 7 , 8 , 10 , 13 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. …”

“…Figure 1 summarizes the resistance rate to nitrofurantoin among strains of E. coli causing UTI. The results come from studies performed in different regions of the world, in different periods, and in groups of different sizes [ 2 , 7 , 8 , 10 , 13 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. In most cases, the percentage of resistance to nitrofurantoin was low and often did not exceed 3%.…”