Urinary tract infection: bacterial etiologies, antimicrobial susceptibility profile and associated risk factors in diabetic patients attending hawassa university comprehensive specialized hospital, hawassa, south Ethiopia

Abstract

Back ground: Urinary Tract Infections are one of the most prevalent extra-intestinal bacterial infections, and is responsible for considerable morbidity, particularly if it is unrecognized or untreated. Diabetes mellitus causes several abnormalities of the host immune system that may result in a higher risk of infections like urinary tract infections. The improper and irrational use of many antibiotics resulted in antimicrobial resistant strains to become a major health problem throughout the world including Ethiopia. Objectives: The aim of this study was to assess etiology, risk factors and antimicrobial susceptibility pattern of uropathogenic bacteria isolated from diabetic patients. Methods: A hospital based prospective cross sectional study was conducted on diabetic patients from March to May, 2017. Demographic and clinical data were collected by using questionnaires. Clean catch mid-stream urine samples were collected and isolation, identification, and antimicrobial susceptibility tests were done using standard bacteriological procedures. Data entry and statistical analysis were performed by using SPSS version 21 statistical software package. Results: Two hundred forty seven patients were included in this study and the overall prevalence of significant bacteriuria was 10.5%. Significant bacteriuria was significantly associated with age and body mass index. The predominant bacteria isolate was E. coli 12(46.2%) followed by Coagulase negative staphylococcus 7(26.9%). Gram negative bacteria showed high rate of sensitivity (94.1%) to Nitrofurantoin and Norfloxacine. Gram positive bacteria showed 100% sensitive for Amoxacillin-Clavunic acid. Multidrug resistance to two or more drug was observed in 19 (73.1%) of bacterial isolates. Conclusion and Recommendation: Significant bacteriuria had been observed from 10.5 % of diabetic patients. Nitrofurantoin, Norfloxacine and Amoxacillin-Clavunic acid can be used for empiric treatment. Regular monitoring of susceptibility pattern of uropathogens should be essential for optimal empirical therapy of diabetic patients with urinary tract infections.