Ghana Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.
National Public Health Laboratories, Ministry of Health, Banjul, The Gambia.
BMC Infect Dis. 2023 Oct 25;23(1):723. doi: 10.1186/s12879-023-08373-y.
Antimicrobial resistance poses a public health threat for the treatment of community-acquired urinary tract infections. This study determined the susceptibility patterns of uropathogens and associated risk factors among outpatients diagnosed with urinary tract infections at the Kanifing General Hospital in the Gambia.
A cross-sectional analytic study was conducted among patients with suspected urinary tract infections at Kanifing General Hospital from March to May 2021. Data on socio-demographic and other risk factors were collected from the study participants using a structured pre-tested questionnaire. Mid-stream urine samples were collected, and bacteria identification and antimicrobial susceptibility testing done using standard microbiological methods. Descriptive and inferential statistical analysis were done to determine factors associated with urinary tract infection at 95% confidence level and a p -value < 0.05.
A total of 422 patients were enrolled with 82.5% (348/422) being females. The prevalence of community acquired urinary tract infection was 12.8% (54/422). Escherichia coli was the most prevalent isolate (74.1%, 40/54), followed by Klebsiella spp (8.5%, 10/54). Antimicrobial resistance was highest for Ampicillin (87.0%, 47/54), Trimethoprim/Sulfamethoxazole (77.8%, 42/54) and Tetracycline (75.9%, 41/54). Uropathogens sensitivity was 77.8% (42/54) for Nitrofurantoin and 75.9% (41/54) for Ceftazidime. Being female (aOR 5.90 95% CI = 1.48-23.67), previous history of urinary tract infection (aOR 2.34, 95% CI = 1.06-5.14), use of unprescribed antibiotics (aOR 2.0, 95% CI = 1.05-3.62) and having no formal education (aOR 8.02, 95% CI = 1.04-62.0) were significant factors associated for having uropathogenic bacterial infection.
E. coli was the most prevalent uropathogen isolated. Ciprofloxacin, Nitrofurantoin and Ceftazidime were the most sensitive antibiotics. Routine surveillance of susceptibility of uropathogenic bacteria would be helpful to update clinicians on the choice of antibiotics.
抗菌药物耐药性对治疗社区获得性尿路感染构成了公共卫生威胁。本研究旨在确定冈比亚卡尼芬综合医院门诊诊断为尿路感染患者的尿病原体敏感性模式和相关危险因素。
本横断面分析性研究于 2021 年 3 月至 5 月在卡尼芬综合医院疑似尿路感染患者中进行。使用经过预测试的结构化问卷从研究参与者那里收集社会人口统计学和其他危险因素的数据。采集中段尿液样本，采用标准微生物学方法进行细菌鉴定和抗菌药物敏感性试验。使用 95%置信水平和 p 值 < 0.05 的推断性统计分析来确定与尿路感染相关的因素。
共纳入 422 名患者，其中 82.5%（348/422）为女性。社区获得性尿路感染的患病率为 12.8%（54/422）。大肠埃希菌是最常见的分离株（74.1%，40/54），其次是克雷伯菌属（8.5%，10/54）。氨苄西林（87.0%，47/54）、复方磺胺甲噁唑（77.8%，42/54）和四环素（75.9%，41/54）的抗菌药物耐药率最高。呋喃妥因（77.8%，42/54）和头孢他啶（75.9%，41/54）对尿病原体的敏感性分别为 77.8%和 75.9%。女性（aOR 5.90 95% CI=1.48-23.67）、尿路感染史（aOR 2.34，95% CI=1.06-5.14）、使用未经处方的抗生素（aOR 2.0，95% CI=1.05-3.62）和未接受正规教育（aOR 8.02，95% CI=1.04-62.0）是与尿病原体细菌感染相关的显著因素。
大肠埃希菌是最常见的尿病原体。环丙沙星、呋喃妥因和头孢他啶是最敏感的抗生素。常规监测尿病原体的敏感性有助于更新临床医生对抗生素选择的认识。
