Prevalence and Genotypic Characterization of Extended Spectrum Beta-Lactamase Uropathogens Isolated from Refugees with Urinary Tract Infections in Nakivale Refugee Settlement camp, Southwestern Uganda

Abstract

BackgroundWorld Health Organization approximates that one in four individuals have had at least one UTI episode requiring treatment with an antimicrobial agent by the teen age. At Nakivale refugee camp, the overwhelming number of refugees often associated with poor living conditions such as communal bathrooms and toilets and multiple sex partners do predispose the refuges to urinary tract infections.AimTo determine the prevalence of bacterial community-onset urinary tract infections among refugees in Nakivale refugee settlement and determine the antimicrobial susceptibility patterns of the isolated pathogens.MethodsThis study was a cross-sectional study, that included 216 outpatients attending Nakivale Health Centre III between July and September 2020.ResultsPrevalence of UTI was 24.1% (52/216). The majority 86(39.81%) of the refugees were from DR Congo, followed by those from Somalia 58(26.85%). The commonest causative agent was Staphylococcus aureus 22/52 (42.31%) of total isolates, followed by Escherichia coli 21/52(40.38%). Multidrug resistant isolates accounted for 71.15% (37/52) and mono resistance was 26.92% (14/52). Out of the 52 bacterial isolates, 30 (58%) were Extended-Spectrum Beta-Lactamase organisms (ESBLs). Twenty-one (70.0%) isolates were ESBL producers while 9(30%) were non-ESBL producers. Both blaTEM and blaCTX-M were 62.5% each while blaSHV detected was 37.5%.ConclusionsThe prevalence of UTI among refugees in Nakivale settlement is high with Staphylococcus aureus and Escherichia coli as the commonest causes of UTI. There is a high rate of multidrug resistance to common drugs used to treat UTI. The prevalence of ESBL-producing Enterobacteriaceae is high and the common ESBL genes are blaTEM and blaCTX-