Bacteriological profile and antibiotic resistance pattern of urinary tract pathogens isolated at National Referral Laboratory, Ethiopian Public Health Institute

Abstract

Background: Urinary Tract Infection (UTI) most commonly affects humans next to respiratory and gastro-intestinal infections. It is caused by various ranges of bacterial pathogens with varying patterns of antibiotic resistances.

Objective: To determine the profile of bacterial pathogens causing Urinary Tract Infection and their antibiotic resistance patterns.

Methods: This is a retrospective study that used data from Clinical Bacteriology and Mycology National Reference laboratory of the Ethiopian Public Health Institute (EPHI), January 2014 to December 2015. Information on patients’ demography and identified pathogens as well as their sensitivity pattern to various antibiotics are routinely documented in the laboratory registration book. The raw data was compiled and entered to spread sheet to compute proportion using Microsoft Excel and Multi-drug resistant strains were analyzed using SPSS Version 20.

Results: The overall prevalence of urinary tract infection was 30.5 % (269 of 882). Of these, above two-thirds of the infection was in females (68 %, 183 of 269).  Escherichia coli accounted about half of bacterial pathogens (48.3%, n= 130) and below one fifths were due to Klebseilla species (13%, n=35.). Among Gram positive isolates, coagulase negative Staphylococcus and Staphylococcus aureus account 12.8% (n=33) and 10.4 % (n= 28), respectively.  Gram negative bacteria pathogens showed extreme resistance to ampicillin (96.7 %) and less resistant to amikacin (8.8 %) while the resistance rate of Gram positive bacteria isolated in this study range from16.2% (nitrofurantion) to 85.7 % (cotrimoxazole).Multidrug resistance was noted for   Klebsiella spp (71 %), E. coli (55 %), Enterobacter spp (50%) and Staphylococcus aureus (25%)

Conclusion: This study documented high prevalence of Urinary Tract Infection caused by Gram negative bacterial pathogens. These pathogens are also highly resistant to a range of commonly used antimicrobials with significant proportion of them being Multi-drug resistant (MDR). Therefore, we recommend regular surveillance and monitoring to be put in place that would eventually provide necessary information for decision makers.