Prevalence, risk factors and antimicrobial susceptibility pattern of uropathogenic escherichia coli among patients presenting with urinary tract infections at International Hospital, Kampala

Abstract

Urinary tract infections are the most common type of bacterial infection diagnosed today and Escherichia coli is the most frequent uropathogenic microorganism isolated with increasing antimicrobial resistance against common antibiotics. A descriptive cross-sectional study was carried out to determine the prevalence, risk factor and susceptibility pattern of uropathogenic Escherichia coli among UTI patients at IHK from January-March 2024. Urine samples were cultured on MacConkey agar media and antimicrobial susceptibility of E. coli colonies were done using VITEK 2 compact system while structured questionnaires were used to gather data on sociodemographic characteristics and risk factors. The prevalence of Escherichia coli was 21.0% while 3.0% had mixed infections and 24.0% of the patients had infections with other organisms isolated. The risk factor associated with E. coli infection were female (OR=1.18; CI=1.697-2.025), youth below 30 years (OR=1.83; CI=0.445-1.577) and the unmarried (single) patients (OR=1.69; CI=0.941-3.038). Escherichia coli isolates were susceptible to Piperacillin-tazobactam (100%), Nitrofurantoin (94.9%), Co-Amoxycalv (87.4%), Atreonam (79.7%). However, Escherichia coli isolates were highly resistant to most antimicrobials, especially Cefixime & cefotaxime at 100%, ceftazidin & ciprofloxacin at 90%, Meropenem (57%) while amoxicillin & Cotrimoxazole at 78.5% and 65.8% respectively. Therefore, the study recommended that; antimicrobial susceptibility be done on all urine sample from UTI patients before prescription of antibiotics, health education of the population at risk to reduce exposure to Escherichia coli, only trained personnel to prescribe antibiotics for treatment of UTI and susceptible new drug combinations be used in the treatment of UTI caused by Escherichia coli while resistant drugs should not be used for empirical treatment of UTI.