Cover Image

Urinary Tract Infection: Bacterial etiologies, drug resistance profile and associated risk factors among diabetic patients attending Nekemte Referral Hospital

kebamo abate Selamu, Dabsu Regea, Deressa Alemayehu, Gebire Mohammed

Abstract


In diabetic patients, there is increased risk of urinary tract infections (UTIs). Hence, current information on antimicrobial resistance and the prevalence of the pathogenic bacteria need to be available at national and local levels to guide the rational use of the existing antimicrobials. This study was conducted to determine the prevalence of UTIs, risk factors and antimicrobial resistance pattern of the bacterial isolates from diabetic patients in Nekemte Referral Hospital (NRH). An institution based cross-sectional study was conducted on 200 diabetic patients, who were attending the study setting for a clinical check-up during the study period. The overall prevalence of UTIs was 16.5% among the study population with the prevalence being higher among aged patients and females. Multivariate analysis revealed that level of education, history of UTIs and glucosuria was significantly associated with UTIs. Thirty-three bacterial uropathogens, total, were isolated with S. aureus (24.2%) and CN Staphylococcus spp (24.2%), E. coli (12.1%) and K. pneumonia (12.1%) being the most common isolates. The microbes showed highest level of resistance to penicillin G (97.0%), and ampicillin (93.9%); and lowest level of resistance to ceftriaxone (50.0%) and vancomycin (52.9%). In conclusion, majority of isolated bacteria were resistant to antibiotics used in the study setting. This calls for attention of health professionals to consider the resistance pattern in their clinical practice. Most importantly, this finding may be used to control trends of antibiotic-resistance, to develop local antibiotic policies and to assist clinicians in the rational choice of antibiotics therapy; thus, to prevent indiscriminate use of antibiotics.


Keywords


Antimicrobial resistance; Ethiopia; prevalence; risk factors; urinary tract infections; uropathogens

References


Zimmet P, Alberti K, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001, 414:782-787

Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014, 103:137-149

Burekovic A, Dizdarevic–Bostandzic A, Godinjak A. Poorly Regulated Blood Glucose in Diabetic Patients – predictor of Acute Infections. Med Arh. 2014, 68(3):163-166

Al-Rubeaan K, Moharram O, Al-Naqeb D, Hassan A, Rafiullah M. Prevalence of urinary tract infection and risk factors among Saudi patients with diabetes. World J Urol. 2013, 31:573-578

Mubarak AA, Ashraf AM, El-hag M, Raza MA, Majed A. Prevalence of urinary tract infections among diabetes mellitus and non-diabetic patients attending a teaching hospital in Ajman , UAE. Gulf Medical Journal. 2012, 1(S1):s228-s232

Lin T, Chen G, Chen Y, Huang C, Ng S. Aging and recurrent urinary tract infections are associated with bladder dysfunction in type 2 diabetes. Taiwan J Obstet Gynecol. 2012, 51(3):381-6. Available from: http://dx.doi.org/10.1016/j.tjog.2012.07.011

Minardi D, D’Anzeo G, Cantoro D, Conti A, Muzzonigro G. Urinary tract infections in women : etiology and treatment options. Int J Gen Med. 2011, 4:333-343

Ababa A, Abebe SM, Berhane Y, Worku A, Alemu S, Assefa A, et al. Glimpse into the hidden aspects of urinary tract infection in patients with diabetes mellitus and prostatomegaly. BMC Res Notes.2014, 3(13):889-898

Beyene G, Tsegaye W. Bacterialuropathogens inurinary tract infection and antibiotic susceptability pattern in Jimma University Specialized Hospital, Southwest Ethiopia. Ethiop J Heal Sci. 2011, 21(2):141-146

Yismaw G, Asrat D, Woldeamanuel Y, Chandrashekhar G. Urinary Tract Infection : Bacterial etiologies, drug resistance profile and associated risk factors in diabetic patients attending Gondar University. European Journal of Experimental Biology. 201 2012, 2(4):889-898

Samuel OO, Mathew AO, Agboola D, Mopelola A, Joshua O, Tosin A, et al. Asymptomatic Urinary Tract Infection In Diabetic Patients In Ago –Iwoye, Ogun State, Nigeria. J Am Sci. 2014, 10(4):72-78

Moges F, Genetu AB. Antibiotic sensitivities of common bacterial pathogens in urinary tract infections at Gondar Hospital , Ethiopia. East Afr Med J. 2002, 79(3):140-142

Abejew AA, Denboba AA, Mekonnen AG. Prevalence and antibiotic resistance pattern of urinary tract bacterial infections in Dessie area. BMC Res Notes. 2014; 7: 687

Craig J, Simpson J, Williams G, Lowe A, Reynolds G, McTaggart S, et al. Antibiotic prophylaxis and recurrent urinary tract infection in children. N Engl J Med. 2009, 361:1748-1759

Eshetie S, Kumera G, Mekonnen F. Multidrug resistant Escherichia coli strains isolated from urine sample , University of Gondar Hospital, Northwest Ethiopia. J Coast Life Med. 2016, 4(2):140-142

Hall V, Thomsen R, Henriksen O, Lohse N. Diabetes in Sub Saharan Africa 1999-2011: epidemiology and public health implications. A systematic review. BMC Public Health. 2011, 11:564

Schneeberger C, Kazemier B, Geerlings S. Asymptomatic bacteriuria and urinary tract infections in special patient groups: women with diabetes Mellitus and pregnant women. Curr Opin Infect Dis. 2014, 27(1):108-114

Melaku S, Kibret M, Abera B. Antibiogram of nosocomial urinary tract infections in Felege Hiwot referral hospital , Ethiopia. Afr Health Sci. 2012, 12(2):134-139

Cheesebrough M. Medical laboratory manual for tropical countries. Microbiology volume II. London UK: Cambridge University press; 1998. p. 251-260

(NCCLS) NC for CLS. Performance standards of antimicrobial susceptibility, NCCLS approved standards M 100-59 National Committee for Clinical Laboratory Standards. 2012

Odoki M, Bazira J, Ml M, Agwu E. Health-point survey of bacteria urinary tract infections among suspected diabetic patients attending clinics in Bushenyi district of Uganda. Special Bacterial Pathogens Journal. 2015, 1(1):1-5

Chiţă T, Licker M, Sima A, Vlad A, Timar B, Sabo P, et al. Prevalence of urinary tract infections in diabetic patients. Rom J Diabetes Nutr Metab Dis. 2013, 20(2):99-105

Maharjan MN, Mandal KP, Sharma K V. Comparative Study among the Bacterial Causes of Urinary Tract Infection in Diabetic and Non-Diabetic Patients Visiting Alka Hospital , Lalitpur. 2015

Ampaire L, Butoto A, Orikiriza P, Muhwezi O. Bacterial and Drug Susceptibility Profiles of Urinary Tract Infection in Diabetes Mellitus Patients at Mbarara Regional Referral Hospital, Uganda. British Microbiology Research Journal, 2015, 9:1-5

Sewify M, Nair S, Warsame S, Murad M, Alhubail A, Behbehani K, et al. Prevalence of Urinary Tract Infection and Antimicrobial Susceptibility among Diabetic Patients with Controlled and Uncontrolled Glycemia in Kuwait. J Diabetes Res. 2016, 2016: 6573215

Chaudhary B, Chandra C, Shukla S. Bacteriology of urinary tract infection and antibiotic susceptability pattern among diabetic patients. Int J Bioassays. 2014, 3(8):3224-3227

Alo MN, Saidu AY, Ugah UI, Alhassan M. Prevalence and Antbiogram of Bacterial Isolates Causing Urinary Tract Infections at Federal Teaching Hospital Abakaliki I ( FETHA I ). British Microbiology Research Journal. 2015, 8(2):403-417

Awaness A, Al-Saadi M, Aadoas S. Antibiotics resistance in recurrent urinary tract infection. Kufa Med J. 2000, 3:159

Rowe TA, Juthani-Mehta M. Urinary tract infection in older adults. Aging health. 2013, 9(5):1-15

James R, Hijaz A. Lower urinary tract symptoms in women with diabetes mellitus: a current review. Curr Urol Rep. 2014, 15(10):440

Top K, Buet A, Whittier S, Ratner A, Saiman L. Predictors of Staphylococcus aureus rectovaginal colonization in pregnant women and risk for maternal and neonatal infections. J Pediatr Infect Dis Soc. 2012, 1(1):7-15

Stefaniuk E, Suchocka U, Bosacka K, Hryniewicz W. Etiology and antibiotic susceptibility of bacterial pathogens responsible for community-acquired urinary tract infections in Poland. Eur J Clin Microbiol Infect Dis. 2016, 35(8):1363-1369

Kline KA, Lewis AL. Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract Kimberly. Microbiol Spectr Author Manuscr. 2016, 4(2)

Bell BG, Schellevis F, Stobberingh E, Goossens H, Pringle M. A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect Dis. 2014, 1-25


Full Text: PDF

Refbacks

  • There are currently no refbacks.


AJCMicrob (ISSN 2572-5815) Copyright © 2012-2018. All rights reserved. Published by Ivy Union Publishing, 3204 Valley Rush Dr, Apex, North Carolina 27502, United States