Prevalence of E. coli as a causative agent of urinary tract infections and its drug susceptibility patterns among pregnant mothers seeking medicare at Kisii teaching and referral hospital, Kenya

Abstract

Background: E-coli, a gram-negative entero-bacteria has been associated with urinary tract infections (UTIs) and antimicrobial resistances in human and animals. This study aimed at establishing the prevalence of E. coli among other bacteria causing UTIs in pregnant women seeking Medicare at Kisii teaching and referral hospital (KTRH), Kenya and to establish the drug susceptibility patterns of the isolated E. coli. Setting-The project was done at Kisii teaching and referral hospital, Kenya.Methods: This hospital based experimental and cross-sectional study conducted in 3 months between March and June 2020 involved 119 pregnant women whose urine samples were cultured on Cysteine Leucine Electrolyte deficiency media (CLED) at 370C overnight and sub-cultured on Mueller Hinton media. Bacterial identification was done by Gram stain and biochemical characterization using indole, methyl-red, Voges-Proskaur and citrate tests while susceptibility tests were conducted by Kirby Bauer disc diffusion technique.Results: Out of the 119 urine samples, E. coli 28 (23.5%) was the second most prevalent after S. aureus 40 (33.6%). Others included S. epidermidis 27 (22.7%), and Proteus spp. 9 (7.6%). All E. coli isolates, 28 (100%) demonstrated resistance to sulfamethoxazole followed by amoxyclave 24 (85.75%), and ceftriaxone 20 (71.42%). They were least resistant to gentamycin 4 (14. 28%) and ofloxacin 6 (21.42%).Conclusions: E. coli which largely exists as a commensal can cause UTIs and could be possessing antimicrobial resistant genes responsible for treatment failure. This demands for new effective therapeutic alternatives and more research on bacterial drug resistant.

Phenotypic and Genotypic Characterization of Extended Spectrum Beta-Lactamases Producing Bacteria Causing Urinary Tract Infections among Expectant Women Attending Antenatal Clinic at Ruiru Sub County Hospital, Kenya

“…Multi-drug resistance limits the therapeutic options leading to increased morbidity health care costs [23]. A similar study by [24] in Kisii, Kenya revealed E. coli as the most common organism causing UTI in pregnancy and the isolates demonstrated high resistance to sulfamethoxazole (100%), augumentin (85.8%) and ceftriaxone (71.4%). Our study disagrees with [7] in Burkina Faso where among E. coli isolates resistance rates to ampicillin and cotrimoxazole were (65.8%) and (64.4%) respectively.…”

Molecular Characterization of Plasmid-Mediated Quinolone resistance in Urinary Escherichia coli from some Healthcentres in Nasarawa-West Senatorial District, Nasarawa State, Nigeria

“…Escherichia coli (E. coli) are Gram negative rod-shape facultative anaerobic bacteria belonging to the family Enterobacteriaceae. This organism is widely known as the most common etiological agent of Urinary tract infections (UTIs) causing about 75-80% of the UTIs in both hospital and community setting [1,2,3] .The treatment and control of UTIs are accomplished through therapy with different classes of antibiotics namely; β-lactam, fluoroquinolones, aminoglycosides and sulfamethoxazole/trimethoprim [4] and among the antibiotics mentioned, fluoroquinolones is widely used as empirical treatment of complicated and non-complicated UTIs [5,6] . Fluoroquinolones are synthetic, targeting enzymes involved in bacterial DNA replication [7,8] .…”

Prevalence, antimicrobial susceptibility profile, and associated risk factors of uropathogenic Escherichia coli among pregnant women attending Dr. Sumait Hospital Mogadishu, Somalia

“…pregnant women were positive for Escherichia coli. A higher prevalence was reported in Kenya at 23.5%(21), southeast Ethiopia at 27.3% (22), and south-western Uganda at 28.78%(23). The variation may result from local social norms, environmental factors, personal hygiene expectations, and healthcare utilization patterns.…”