Ciprofloxacin resistance rate and common uropathogens among patients attending urology clinic at Bugando Medical Centre, Mwanza, Tanzania
- Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS – Bugando] 02.09.2022
- Pages xii; 38 Includes Refferences and Appendices
Abstract:
Background: Antimicrobial resistance occurs when infectious organisms change over time and fail to respond to medicines. The aim of this study was to determine the resistance rate to ciprofloxacin, nitrofurantoin and common uropathogens among patients attending Bugando Medical Centre so as to affect the current practice on ciprofloxacin and nitrofurantroin use.
Method: A total of 3617 urine culture and susceptibility results data recorded from 2017-2021 was collected, cleaned using Microsoft Excel 2016 and analyzed using SPSS (version 20.0).
Results: More than half (56.8%, n=2055/3617) of culture and susceptibility results were from female patients. Mean age of patients was 29.8 (±28.5). Large proportions of patients were adults 52.5% (n=1996) and most uropathogens were isolated from paediatric out patients 28.0% (n=1018). Majority of isolates was recorded in 2021 44.4% (n=1606). Common uropathogens identified were E.coli (33.3% n= 1205), K.pneumoniae (12.0% n= 433), E.faecalis(5.8% n= 211), S.aureus (6.5% n=234) and P.aeruginosa(3.9% n=141).The resistance rates to ciprofloxacin among common uropathogens ranged from 42.1% to 77.8%, whereby in nitrofurantoin ranges from 10.2% to 82.9%.The resistance rate to ciprofloxacin was observed to decrease with increase in years from 2017-2021, While resistance rate to nitrofurantoin appeared to increase from 2017 to 2021 [P<0.005]. Resistance rate to ciprofloxacin and nitrofurantoin was higher in male patients than female patients [P<0.005], and resistance rate to both drugs was increasing in male patients from 2017-2021 while among female patients the resistance rate was decreasing in the similar order. Resistance rate to ciprofloxacin and nitrofurantoin was higher in adults than in children [P<0.005].
Conclusion: The higher resistance to ciprofloxacin suggest that the drug would not provide adequate empirical therapy to most common uropathogens identified in this study, therefore nitrofurantoin should be considered in the management of uncomplicated urological infections.
= Operational definitions Antimicrobial resistance This is the situation whereby any microbe responsible for urological infections evolve a mechanism that protects him from the antimicrobial effect of ciprofloxacin or nitrofurantoin Operational definitions Community-acquired urological infections These are the urological infections that occur in the community area or 48 hours before hospital admission Operational definitions Empirical treatment This is the administration of ciprofloxacin or nitrofurantoin to patients with clinical presentation of urological infections while waiting for the laboratory results Operational definitions Healthcare-associated urological infections These are the urological infections that occur 48 hours after hospital admission (without incubation at time of admission) or 3 days after discharge Operational definitions Uropathogen This is any bacteria or fungi that can cause either upper urological infection or lower urological infection Keywords: Ciprofloxacin, Nitrofurantoin, Resistance, Uropathogen
= Abbreviations BMC Bugando Medical Centre CUHAS Catholic University of Health and Allied Sciences DNA Deoxyribonucleic acid ESBL Extended Spectrum Beta Lactamase HIV Human Immunodeficiency Virus UTI Urinary Tract Infection WHO World Health Organization