prevalence and antmicrobial susceptibility profile of uropathogenes and associated risk factors of urinary tract infection: among diabetic and non-diabetic patients attending mizan-tepi university teaching hospital, aman, southwest Ethiopia

Abstract

Background: Urinary tract infection, the most common bacterial infections in urinary tract, is a major cause of morbidity particularly in patients with diabetes mellitus. Its empirical treatment is becoming difficult because of appearance of uropathogens with increasing resistance to antimicrobial agents worldwide. Local susceptibility pattern of uropathogens is, therefore, important. Objective: The aim of the study was to determine the prevalence and antimicrobial susceptibility profile of uropathogenes and associated risk factors of urinary tract infection among diabetic and non-diabetic patients. Materials and methods: A facility based comparative cross-sectional study was carried out involving 319 diabetic patients and 319 non-diabetic patients at Mizan Tepi University Teaching Hospital from April to July 30,2018. Structured questionnaire was used for collecting the data pertaining to socio-demographic characteristics and possible risk factors. Midstream urine was collected and cultured onto bacteriological media. All the positive urine cultures showing significant bacteriuria were further subjected to biochemical tests. Antibacterial susceptibility was determined by standard Kirby Bauer’s disc diffusion method. Data were entered into Epidata version 3.1 and exported to SPSS version 20.2 for analysis. Statistically significant bacteriuria was set a P values< 0.05. Result: Significant bacteriuria was detected in 48/319(15.0%) diabetic patients and in 18/319(5.6%) of non-diabetic patients. The most predominant isolate in diabetic and non- diabetic patient was E. coli at 18.8% and 27.8% prevalence. All isolates were 100% sensitive to Nitrofurantoin, Gentamycin and Ciprofloxacin and resistant to Ampicillin. Females in diabetic patients[AOR,2.001;95%CI:1.56-4.311], and females in non- diabetic patients[AOR,2.201;95%CI;1.360-4.451], fasting blood sugar greater than 126mg/dl [AOR:4.248; 95% CI;0.848-11.253], glycosuria [AOR:2.030; 95% CI;1.851- 6.752] and history of urinary tract infection [AOR:1.123; 95%CI;1.001-3.701] were found to be statistically associated to significant bacteriuria. Conclusion and recommendation: The prevalence of uropathogenes in diabetic patients and the resistances of most isolates to commonly used antibiotics is a major concern. Diabetic patients should be screened for urinary tract infection.