A retrospective study of the antimicrobial susceptibility of uropathogens isolated in microbiology laboratory of Mengo Hospital, Kampala Uganda.

Abstract

Background: Urinary tract infection is the second most common type of infection and the problem is further compounded by the emergence of drug resistance in bacterial uropathogens. The aim of this study was to determine the spectrum of bacterial uropathogens and their drug resistant pattern.

Methods: The culture and sensitivity data of the uropathogens from suspected cases of UTI were collected from the records of Microbiology Department of Mengo Hospital for a two year study period (between January 2017 and December, 2018). Midstream urine samples were processed for microscopy and culture, and the organisms were identified by standard methods. Antibiotic susceptibility was carried out by Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines. Descriptive statistics were used to analyze the data.

Results: A total of 960 urine samples analyzed, female patients accounted for a total of 624 (65%) while the male patients accounted for a total of 336 (35%). The total number of patients with positive urine cultures was 420 urine samples, while 540 patients were negative for urine culture. Escherichia coli (32.4%) was the most common organism followed by Staph aureus (18.6%). E. coli was least resistant to imipenem (5%) and amikacin (15%) and was highly resistant to co-trimoxazole (84.3%) and ampicillin (79.3%). Staph aureus were least resistant to Imipenem (11%) and Amoxyclav (19.8%), and were highly resistant to Cotrimoxazole (88.6%) and Nalidixic acid (79.8%). The overall resistance pattern of antibiotics to uropathogens was highest to Cotrimoxazole (83.8%) and lowest with imipenem (15.1%) and Amikacin (22.5%).

Conclusions: The uropathogens showed high levels of resistance to multiple urinary antimicrobial agents hence routine monitoring of drug resistance pattern will be necessary to identify the resistance trends. This will help in the empirical treatment of UTIs by the clinicians.