Antibiotics susceptibility patterns of uropathogenic bacteria: a cross-sectional analytic study at Kanifng General Hospital, The Gambia

Abstract

Background Antimicrobial resistance poses a public health threat for the treatment of community-acquired uri‑ nary tract infections. This study determined the susceptibility patterns of uropathogens and associated risk factors among outpatients diagnosed with urinary tract infections at the Kanifng General Hospital in the Gambia. Methods A cross-sectional analytic study was conducted among patients with suspected urinary tract infec‑ tions at Kanifng General Hospital from March to May 2021. Data on socio-demographic and other risk factors were collected from the study participants using a structured pre-tested questionnaire. Mid-stream urine samples were collected, and bacteria identifcation and antimicrobial susceptibility testing done using standard microbiological methods. Descriptive and inferential statistical analysis were done to determine factors associated with urinary tract infection at 95% confdence level and a p -value<0.05. Results A total of 422 patients were enrolled with 82.5% (348/422) being females. The prevalence of community acquired urinary tract infection was 12.8% (54/422). Escherichia coli was the most prevalent isolate (74.1%, 40/54), fol‑ lowed by Klebsiella spp (8.5%, 10/54). Antimicrobial resistance was highest for Ampicillin (87.0%, 47/54), Trimethoprim/ Sulfamethoxazole (77.8%, 42/54) and Tetracycline (75.9%, 41/54). Uropathogens sensitivity was 77.8% (42/54) for Nitro‑ furantoin and 75.9% (41/54) for Ceftazidime. Being female (aOR 5.90 95% CI=1.48–23.67), previous history of urinary tract infection (aOR 2.34, 95% CI=1.06–5.14), use of unprescribed antibiotics (aOR 2.0, 95% CI=1.05–3.62) and hav‑ ing no formal education (aOR 8.02, 95% CI=1.04–62.0) were signifcant factors associated for having uropathogenic bacterial infection. Conclusion E. coli was the most prevalent uropathogen isolated. Ciprofoxacin, Nitrofurantoin and Ceftazidime were the most sensitive antibiotics. Routine surveillance of susceptibility of uropathogenic bacteria would be helpful to update clinicians on the choice of antibiotics.