Bacterial Profile, Antibiotic Susceptibility Pattern and Associated Factors Among Patients Attending Adult OPD at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia

Abstract

Background

Urinary tract infection (UTI) is a common health problem occurring when infectious agents colonize, invade, and propagate the urinary tract including the urethra, bladder, renal pelvis, or renal parenchyma. The study aimed to determine the prevalence of symptomatic UTI, drug resistance pattern, and its associated factors among patients attending adult outpatient department (OPD) at Hawassa University Comprehensive Specialized Hospital (HUCSH).

Methods

A cross-sectional study was conducted from October 2018 to February 2019 among adults ≥18 years old with symptoms of UTI. Processing of specimens for culture and identification was done. Antimicrobial susceptibility was done for positive urine cultures. Data entry and analysis were performed using SPSS version 23.0 software. Bivariate and multivariate logistic regression analysis test results were used.

Results

The overall prevalence of symptomatic urinary tract infection was 32.8% (95% CI: 28.3–37.6). The predominant isolated bacteria was E. coli 46 (36.2%) followed by S. aureus 21 (16.5%). Gram-negative bacteria were a high level of resistance to ampicillin (71.4%), and tetracycline (68.2%). Gram-positive bacteria were highly resistant to norfloxacin (77.7%). The overall prevalence of multi-drug resistant isolates was 102 (80.3%). Being female, no formal education, and self-medication history had more likely cause UTI.

Conclusion

Urinary tract infection (UTI) among adults was prevalent in the study area. Being female, educational status and self-medication history had a significant association with UTI. Resistance to ampicillin, tetracycline, and norfloxacin was high. Therefore, culture and antibiotic susceptibility testing should be routinely used for the proper management of patients with UTI.

Keywords:

• urinary tract infection
• antimicrobial susceptibility
• Hawassa
• Southern Ethiopia

Acknowledgments

The authors would like to thank Hawassa University College of Medicine and Health Sciences and School of Medical Laboratory Science for sponsoring the research and Hawassa University Comprehensive Specialized Hospital for unreserved material and reagent supply that made the study possible. We extend our gratitude to all data collectors for their cooperation and efforts during the data collection.

Abbreviations

AST, antibiotic susceptibility test; ATCC, American Type Culture Collection; BAP, blood agar plate; CDC, Center for Disease Control and prevention; CFU, colony forming unit; CLSI, Clinical and Laboratory Standards Institute; CSA, Central Statistical Agency; CoNs, coagulase-negative Staphylococcus; EDHS, Ethiopian Demographic Health Survey; H₂O₂, hydrogen peroxide; H₂S, hydrogen sulfide; HUCSH, Hawassa University Comprehensive Specialized Hospital; IRB, Institutional Review Board; KB, Kirby Bauer; MDR, multi-drug resistance; MHA, Muller-Hinton agar; NB, nutrient broth; OPD, outpatient department; SGC, School of Graduate Committee; SNNPRs, Southern Nations Nationalities People Regional State; SPSS, Statistical Package for Social Science; SUTI, symptomatic urinary tract infection; TSI, triple sugar iron; UTI, urinary tract infection; WBCs, white blood cells; WHO, World Health Organization.

Data Sharing Statement

The data that support the findings of this study will be available from the corresponding author upon reasonable request.

Ethics Approval and Informed Consent

Ethical clearance was obtained from Hawassa University College of Medicine and Health Science Institution Review Board (IRB) Ref. No IRB/012/10. A permission and support letter was obtained from the Hospital administration office. Data were collected from study participants after explaining the purpose and procedure of the study and assuring the confidentiality of their results then obtaining informed written consent. The laboratory diagnosis of study participants was done without cost. Both the negative and positive results were given back to the doctor for appropriate management. This study was conducted in accordance with the Declaration of Helsinki.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest in this work.