Community acquired urinary tract infections among adults in Accra, Ghana
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Date
2019-04-23
Journal Title
Journal ISSN
Volume Title
Publisher
Infection and Drug Resistance
Abstract
Background: Urinary tract infection (UTI) is one of the most common bacterial infectious
diseases encountered in clinical practice, and accounts for significant morbidity and high
medical costs. To reduce its public health burden, there is the need for local research data to
address aspects of prevention and management of UTI. The aim of this study was to
investigate community-acquired UTI among adults in Accra, Ghana, including the risk
factors, etiological agents, and antibiotic resistance.
Methods: This was a cross-sectional study involving 307 patients clinically diagnosed with
UTI at the Korle Bu and Mamprobi polyclinics in Accra. Urine specimens were collected
from the study participants and analyzed by culture, microscopy, and dipstick. The bacterial
isolates were identified using standard microbiological methods and tested against
a spectrum of antibiotics by the Kirby Bauer method. Multidrug resistant
Enterobacteriaceae isolates were screened for Extended Spectrum β-lactamase (ESBL)
production by the double disc method, and isolates that tested positive were analyzed by
Polymerase Chain Reaction for ESBL genes. Demographic information and clinical history
of study participants were collected.
Results: Based on the criteria for laboratory confirmed UTI, 31 (10.1%) of the 307 specimens
were positive and the main risk factor of UTI among the study participants was
pregnancy (P=0.02, OR=2.43). The most common uropathogen isolated was Escherichia
coli (48.9%), followed by Klebseilla sp. (16.1%). Prevalence of resistance was highest for
Piperacillin (87.1%) and Amoxicillin+Clavulanic Acid (87.1%) and lowest for Amikacin
(12.9%). Prevalence of multidrug resistance among the uropathogens was 80.1% (25) and the
most common ESBL gene detected was CTX-M-15.
Conclusion: Pregnant women constitute the key risk population of UTI in Accra, while
Amikacin remains a suitable drug for the treatment of febrile UTI. The high prevalence of
multidrug resistance among the uropathogens highlights the need for surveillance of antimicrobial
resistance among these pathogens
Description
Research Article
Keywords
Extended spectrum β-lactamases, Multidrug resistance, Urinary tract infection