Silago Vitus, Keenan Katherine, Mushi Martha F, Kansiime Catherine, Asiimwe Benon, Sunday Benjamin, Bazira Joel, Sandeman Alison, Sabiiti Wilber, Seni Jeremiah, Holden Matthew T G, Mshana Stephen E
Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania.
Geography & Sustainable Development, School of Medicine, University of St Andrews, St Andrews KY16 9AJ, UK.
JAC Antimicrob Resist. 2025 Mar 14;7(2):dlaf038. doi: 10.1093/jacamr/dlaf038. eCollection 2025 Apr.
Increased antimicrobial use during the COVID-19 pandemic has driven antimicrobial resistance (AMR) globally, particularly in resource-limited settings. This study assessed AMR patterns in urinary tract infections (UTIs) in Uganda and Tanzania before and during the pandemic.
A cross-sectional study was conducted among UTI patients at healthcare facilities in Mbarara (Uganda) and Mwanza (Tanzania) between March 2019-September 2020 and January-December 2021. Mid-stream urine samples were collected and analysed following standard procedures. AMR patterns were compared across the two periods.
A total of 5563 patients were enrolled from Mwanza (55.0%, = 3061) and Mbarara (45.0%, = 2502). The overall prevalence of microbiologically confirmed UTIs in Mwanza was 32.5% (999/3060; 95% CI: 30.9%-34.3%), raised from 30.1% (655/2180; 95% CI: 28.1%-32.0%) before to 39.1% (344/880; 95% CI: 35.8%-42.4%) during the pandemic. Whereby, the overall prevalence of microbiologically confirmed UTIs in Mbarara was 24.8% (620/2502; 95% CI: 23.1%-26.5%), decreasing from 27.5% (502/1824; 95% CI: 25.5%-29.6%) before to 17.4% (118/678; 95% CI: 14.6%-20.5%) during the pandemic. The proportion of multidrug-resistant Gram-negative bacteria (MDR-GNB) rose significantly (74% versus 83.4%, = 0.01) while MDR Gram-positive bacteria (MDR-GPB) increased slightly (55.5% versus 56.7%, = 0.45) in Mwanza. Conversely, MDR-GPB increased substantially (31.4% versus 51.6%, = 0.09) while MDR-GNB decreased (67.3% versus 61.9%, = 0.22) in Mbarara.
This study provides critical insights into AMR trends in UTI pathogens in Tanzania and Uganda, emphasizing the need for stringent antimicrobial stewardship, requiring ongoing surveillance and targeted interventions.
2019年冠状病毒病（COVID-19）大流行期间抗菌药物使用增加，在全球范围内推动了抗菌药物耐药性（AMR）的产生，尤其是在资源有限的环境中。本研究评估了乌干达和坦桑尼亚在大流行之前和期间尿路感染（UTI）的AMR模式。
2019年3月至2020年9月以及2021年1月至12月期间，在姆巴拉拉（乌干达）和姆万扎（坦桑尼亚）的医疗机构对UTI患者进行了一项横断面研究。按照标准程序收集并分析中段尿样本。比较了两个时期的AMR模式。
总共招募了5563名患者，其中姆万扎3061名（55.0%），姆巴拉拉2502名（45.0%）。姆万扎微生物学确诊UTI的总体患病率为32.5%（999/3060；95%置信区间：30.9%-34.3%），从大流行前的30.1%（655/2180；95%置信区间：28.1%-32.0%）升至大流行期间的39.1%（344/880；95%置信区间：35.8%-42.4%）。相比之下，姆巴拉拉微生物学确诊UTI的总体患病率为24.8%（620/2502；95%置信区间：23.1%-26.5%），从大流行前的27.5%（502/1824；95%置信区间：25.5%-29.6%）降至大流行期间的17.4%（118/678；95%置信区间：14.6%-20.5%）。姆万扎多重耐药革兰氏阴性菌（MDR-GNB）的比例显著上升（从74%升至83.4%，P = 0.01），而多重耐药革兰氏阳性菌（MDR-GPB）略有增加（从55.5%升至56.7%，P = 0.45）。相反，姆巴拉拉MDR-GPB大幅增加（从31.4%升至51.6%，P = 0.09），而MDR-GNB有所下降（从67.3%降至6l.9%，P = 0.22）。
本研究为坦桑尼亚和乌干达UTI病原体的AMR趋势提供了关键见解，强调了严格抗菌药物管理的必要性，需要持续监测和有针对性的干预措施。
