Antimicrobial susceptibility patterns and associated risk factors of bacterial isolate among urinary tract infection suspected patients at University of Gondar Comprehensive Specialized Hospital North west Ethiopia

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BACKGROUND: Urinary tract infections (UTIs) are the most common infections affecting millions of people worldwide. There is a shortage of comprehensive data addressing the current prevalence, antimicrobial susceptibility pattern, and associated risk factors in clinically suspected UTI patients. OBJECTIVE: To assess the prevalence, bacterial profile, antimicrobial susceptibility pattern and associated risk factors for urinary tract infection among clinically suspected patients. METHOD: A hospital-based cross-sectional study was conducted from May 1, 2023, to November 30, 2023, in patients clinically suspected of having a UTI. Sociodemographic and clinical data were collected using structured questionnaires. A total of 320 patients were enrolled, and a systematic random sampling technique was used to select the studyparticipantsApproximately 5 to 10 ml of morning midstream urine was collected and inoculated primarily on the CLED agar. Thereafter, the isolates were subculture on Blood agar and MacConkey media for identification. The Kirby-Bauer disc diffusion method was used to determine the antibiotic susceptibility pattern of the isolates. Extended-spectrum beta-lactamase and carbapenemase-producing strains were detected using combined disk and modified carbapenem inhibition test methods, respectively. The data were entered and analyzed using SPSS version 27 software. A p value < 0.05 was considered to indicate statistical significance. RESULTS: Of the total participants, 212 (66.25%) were females. The mean age of the participants was 35.99 ± 17.17 years. The prevalence of UTIs was 21.9%. A total of 70 different bacterial isolates were recovered. Of these, 58 (82.9%) and 12 (17.1%) were gram-negative and gram-positive bacterial isolates, respectively. Among the gram-negative bacteria,E.coli isoltes was 34 (58.6%) predominant, followed by K. pneumoniae 22 (37.9%) and P. mirabilis 2 (3.5%), while S. aureus 9 (75%) was prevalent among the gram-positive isolates. Meropenem and nitrofurantoin are effective antibiotics against gram-negative bacteria.The prevalence of multidrug resistance was 71.4%. Approximately 27 (46.6%) and 4 (6.9%) gram-negative isolates were found to be extended-spectrum beta-lactamases and carbapenemase producers, respectively. A history of UTI, catheterization, HIV, and diabetes were independent risk factors associated with UTI (p < 0.05). CONCLUSION: The prevalence of UTIs among clinically suspected patients was high, with increased positivity rates for MDR, ESBL and CP-producing strains. Patients with UTI should have a critical need for appropriate antimicrobial administration and the practice of providing patients with suitable antibioticsAntibiotic should be prescribed based on results obtained from the laboratory diagnosis of AST and complying with local guidelines by considering the most often domestically isolated organisms.

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