Antimicrobial resistance of bacterial uropathogens isolated from adult outpatients with febrile illness at mulago national referral hospital kampala

Abstract

Urinary tract infection has been one of the most common bacterial disease worldwide, this infection has been reported in all age groups and both sexes. Cross sectional study design was conducted from September to November 2021.140 febrile adult outpatients clinically diagnosed with UTI were recruited. Questionnaires wereused tocollect details of participants. Midstream urine specimen was collected then analyzed by microscopy, dipstick and cultured. The bacterial isolates were tested against spectrum of antibiotics such as Amoxicillin clavulanic, Imipenem, piperacillin, chloramphenicol, Nitrofurantoin, rifampin, clindamycin, Vancomycin, Ampicillin, Ciprofloxacin, Erythromycin, Ceftriaxone, Ceftazidime, Gentamycin, Tetracycline, Cotrimoxazole, Cefotaxime, Oxacillin and Cefuroxime by the Kirby Bauer method. Raw data was entered in the laboratory book, transferred to excel sheet and analyzed using Statiscal package for social science Version 23. Pure growth 40(28.8%),12(8.6%) mixed growth and 87(62.6%) had no bacterial growth. The common organisms isolated were Escherichia coli (9.4%), Citrobacter freundi (6.5%), Klebsiella pneumoniae (4.3%), Staphylococcus aureus (4.3%), Enterococcus species (2.9%), Morganella morganii (0.7%) and Proteus mirabilis (0.7%). Isolates showed 100% resistance to Cotrimoxazole and Cefotaxime. Most isolates were susceptible to antibiotics like Amoxicillin clavulanic, Imipenem, Piperacillin and Chloramphenicol. High proportion of isolates were sensitive to antibiotics such as Nitrofurantoin (84%), Rifampin (75%) and clindamycin (75%).Bacterial uropathogens indicated relatively low susceptibility with 25% and 38% to other antibiotics like vancomycin and tetracycline respectively. Early and correct diagnosis of UTI in febrile adult patients is a key to combat misuse of antibiotics in the community since patients shall be enroll for the right antibiotic for prophylaxis.