Urinary Tract Infection among Adults Seeking Medicare at Kiambu Level 5 Hospital, Kenya: Prevalence, Diversity, Antimicrobial Susceptibility Profiles and Possible Risk Factors  

作　　者：Fredrick Wanja Caroline Ngugi Eric Omwenga John Maina John Kiiru Fredrick Wanja;Caroline Ngugi;Eric Omwenga;John Maina;John Kiiru(Department of Medical Microbiology, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya;Department of Microbiology & Parasitological, Kisii University, Kisii, Kenya;Centre of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya)

机构地区：[1]Department of Medical Microbiology, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya [2]Department of Microbiology & Parasitological, Kisii University, Kisii, Kenya [3]Centre of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya

出　　处：《Advances in Microbiology》2021年第8期360-383,共24页微生物学（英文）

摘　　要：Urinary tract infections are among the most prevalent extra-intestinal infections, with high prevalence globally. This cross-sectional study established prevalence of bacterial aetiology causing urinary tract infection (UTI) and their antimicrobial susceptibility profiles. A questionnaire was used to capture socio-demographic data and possible UTI risk factors among the 206 consented adults seeking medicare at Kiambu Level 5 Hospital. The collected midstream urine samples were subjected to dipstick analysis, microscopy and culture for UTI diagnosis. <b>Results:</b> The overall prevalence rate of UTIs was 27.6%, with women’s prevalence rate being significantly higher at 80.7% compared to men 19.2%. Pregnant women had UTI prevalence at 34% which was higher than other sets of participants. Women who did not frequently change their underpants daily had a higher UTI cases at 34.8%. <i>Escherichia coli</i>, <i>Staphylococcus aureus</i> and <i>Klebsiella pneumoniae</i> were the most prevalent bacterial pathogens at 38.5%, 21% and 19.3%, respectively. Antimicrobial sensitivity analysis revealed high resistances towards Sulfamethoxazole and Ampicillin at range between 50% - 85%, suggesting that these drugs are no longer effective for UTI empirical treatment. The resistance patterns towards Cefotaxime, Cefepime and Ciprofloxacin were below 40%. However, more resistance patterns at a range between 14% - 40% revealed towards Amoxicillin-clavulanic and Nitrofurantoin imply that these are drugs remain potent but there is the need to revise the current UTI management guidelines. In addition, to elude treatment failure, innovation of prophylactic measures is key to halt UTI contraction and offer support to pharmaceutical industries that have fewer new antibiotics in the pipeline.Urinary tract infections are among the most prevalent extra-intestinal infections, with high prevalence globally. This cross-sectional study established prevalence of bacterial aetiology causing urinary tract infection (UTI) and their antimicrobial susceptibility profiles. A questionnaire was used to capture socio-demographic data and possible UTI risk factors among the 206 consented adults seeking medicare at Kiambu Level 5 Hospital. The collected midstream urine samples were subjected to dipstick analysis, microscopy and culture for UTI diagnosis. <b>Results:</b> The overall prevalence rate of UTIs was 27.6%, with women’s prevalence rate being significantly higher at 80.7% compared to men 19.2%. Pregnant women had UTI prevalence at 34% which was higher than other sets of participants. Women who did not frequently change their underpants daily had a higher UTI cases at 34.8%. <i>Escherichia coli</i>, <i>Staphylococcus aureus</i> and <i>Klebsiella pneumoniae</i> were the most prevalent bacterial pathogens at 38.5%, 21% and 19.3%, respectively. Antimicrobial sensitivity analysis revealed high resistances towards Sulfamethoxazole and Ampicillin at range between 50% - 85%, suggesting that these drugs are no longer effective for UTI empirical treatment. The resistance patterns towards Cefotaxime, Cefepime and Ciprofloxacin were below 40%. However, more resistance patterns at a range between 14% - 40% revealed towards Amoxicillin-clavulanic and Nitrofurantoin imply that these are drugs remain potent but there is the need to revise the current UTI management guidelines. In addition, to elude treatment failure, innovation of prophylactic measures is key to halt UTI contraction and offer support to pharmaceutical industries that have fewer new antibiotics in the pipeline.

关 键 词：Urinary Tract Infection (UTI) Risk Factors Antimicrobial Resistance and Antimicrobial Susceptibility Profile 

分 类 号：R69[医药卫生—泌尿科学]