Antimicrobial resistance profile of pathogenic isolates among out-patients receiving health care services at Gulu Regional Referral Hospital, Gulu – Uganda

Abstract

Antibiotic resistance poses a profound threat to human health with associated increased mortality rates and the odds ratio of readmission for resistant infections is as high as 1.492 (49.2%). It has increasingly caused high mortality and morbidity especially in low and middle-income communities with limited access to proper diagnosis, antibiotic prescription and use inadequately regulated. In Uganda alone; there was 30,700 associated deaths with 7,100 directly caused by antimicrobial resistance. The study aimed at determining antimicrobial resistance profile of pathogenic isolates among out-patients receiving health care services at Gulu Regional Referral Hospital, Gulu – Uganda. This was a cross-sectional study conducted between January 2024 to April, 2024 on 101 out-patients receiving health care services at Gulu Regional Referral Hospital employing non-probability convenience sampling technique. Structured questionnaire was used to collect the socio-demographic factors and risk factors. The samples were cultured and antibiotic test set for the isolates. Out of the 101 patients, females 55 (54.46%) had a higher level of antibiotic resistance. The most affected age group was 15 to 24 (40.59%) with the mean age of 33.62 (±19.13). Secondary level of education was the most predominant level at 52 (51.49%), higher antibiotic resistance was amongst peasant farmers at 40 (39.60%) than other occupation. Higher antibiotic resistance was amongst family size of 5-7 (51.49%). Purchasing the drugs over the counter and self-medication were the most likely direct associated risk factors to antibiotic resistance. S. aureus was the most predominant bacteria at 24 (23.76%), followed by E. coli at 23 (23.77%), Coagulase negative staphylococcus 18 (17.82%), with the least being S. agalactiae at 2 (1.98%). The others were P. mirabilis at 9 (8.91), followed by K. peumoniae at 6 (5.94%). Acinetobacter spps, E. faecalis, P. vulguris and S. pyogenes were all at 4 (3.96%) respectively, P. aeruginosa (2.97%). The highest antibiotic resistance was recorded in Streptomycin (S) at 100% followed by Nalidixic acid (NA) at 95.24%, Ampicillin (AMP) at 94.87%, Cefuroxime (CXM) at 83.72%. There was complete susceptibility to Amikacin and Imipenem. S. aureus and E. coli continues to be the most widely spread organisms with the purchasing of drugs over the counter and self-medication being the most associated risk factors.