Abstract:
Background: Urinary tract infections are among the most common bacterial infection frequently occur in community and hospital environment. Catheter associated urinary tract infection is a major health care problem responsible for an enormous aggregate burden of morbidity, mortality and increased health care costs. To date, little is known about the type of bacterial pathogens and their antimicrobial susceptibility pattern among catheterized and noncatheterized UTI patients, especially in the study area.
Objective: The aim of this study was to assess the bacterial pathogens, antimicrobial susceptibility pattern and associated risk factors among catheterized and non-catheterized UTI suspected patients at University of Gondar referral hospital.
Methods: A hospital based comparative cross sectional study was conducted from February to May/2017. A total of 208 (70=catheterized and 138=non-catheterized) clinically UTI suspected patients were recruited. After obtaining consent from each study subject, sociodemographic and clinical data were collected using pre tested structured questionnaire. Bacterial isolation from urine was done following standard bacteriological methods and antimicrobial susceptibility pattern was performed using Kirby-Bauer disk diffusion technique. Data was analyzed using SPSS version 20 computer software and p-value<0.05 was considered as statistically significant.
Results: The overall prevalence of culture confirmed UTI (catheterized = 41.4% and non-catheterized =17.4%) was 25.5% (95%CI=19.7 to 31.3%). The predominant bacterial isolate among catheterized and non-catheterized UTI patients was Klebsiella pneumoniae (21.9%) and E. coli (41.67%), respectively. Gram negative isolates were resistant to ampicillin and augmentin (100%) whereas, Gram positive isolates were resistant to cotrimoxazole (91%). Duration of catheter greater than 2 weeks (OR=18.00; 95%CI, 1.787-81.31) among catheterized patients, being female (OR=3.77; 95% CI, 1.30 - 10.1.97; p=0.015) and patients with underlying disease (OR=3.26; 95%CI, 1.15 - 9.27; p=0.027) in non-catheterized patients were significantly associated with UTI.
Conclusion: Catheterized patients for more than two weeks and non-catheterized females and patients with underlying diseases had significantly higher isolation rates of bacterial pathogens. Increasing resistance in pathogens isolated from catheterized UTI patients is frustrating. Rational use of antimicrobial agent should be thought of to prevent the emergence of multidrug resistance. Also, there is a need to establish standard guidelines on the care of catheter for all units in the hospital with a view to preventing nosocomial infections associated with the device in patients.
