A CROSS-SECTIONAL PROSPECTIVE STUDY ON ANTIMICROBIAL RESISTANCE PROFILES OF COMMON BACTERIAL PATHOGENS CAUSING URINARY TRACT INFECTIONS AMONG PATIENTS AT MENGO HOSPITAL, KAMPALA DISTRICT.

Saviour Yoacel Aramalo; Mirriam Akullo; Benjamin Wathum Oromcan

doi:10.51168/sjhrafrica.v6i3.1597

Authors

Saviour Yoacel Aramalo Mengo Hospital Medical Laboratory Training School
Mirriam Akullo Mengo Hospital Medical Laboratory Training School
Benjamin Wathum Oromcan Mengo Hospital Medical Laboratory Training School

DOI:

https://doi.org/10.51168/sjhrafrica.v6i3.1597

Keywords:

Urinary Tract Infection (UTI), Prevalence, Antimicrobial Resistance

Abstract

Introduction

Urinary Tract Infection (UTI) is a common disease affecting all age groups and is increasingly difficult to treat due to antimicrobial resistance.

Methods

This study assessed the prevalence of UTIs and antimicrobial resistance profiles in patients at Mengo Hospital, Kampala. A cross-sectional, prospective study was conducted from March to May 2023. Mid-stream urine samples were analyzed using macroscopic, microscopic, Gram staining, culture, biochemical tests, and antibiotic sensitivity testing. Data was processed and analyzed using SPSS version 25.

Results

The results showed that 70.4% of patients had UTI, with a higher occurrence in females (72.7%) than in males (27.3%). UTI prevalence peaked at 30-39 years (37.5%). Common pathogens were Escherichia coli (20.8%), Staphylococcus aureus (15.2%), and Candida albicans (12%). Antimicrobial resistance was highest against Clindamycin (92%), Erythromycin (89%), and Ciprofloxacin (80%). Imipenem (96%), Meropenem (85%), and Vancomycin (78%) showed better sensitivity.

Conclusions

UTIs and antimicrobial resistance are significant public health concerns at Mengo Hospital. Women and individuals aged 30-39 years are at higher risk. Resistance varies widely, emphasizing the need for targeted antibiotic use.

Recommendations

The current study recommends routine UTI screening for high-risk patients. Antibiotic sensitivity testing should be done before treatment. Empiric therapy should be emphasized with effective antibiotics like Imipenem, Vancomycin, and Meropenem, considering local resistance patterns. Public awareness campaigns on UTI prevention and responsible antibiotic use should be carried out. Further research should be done on UTI epidemiology and resistance patterns to inform healthcare policies.

Author Biographies

Saviour Yoacel Aramalo , Mengo Hospital Medical Laboratory Training School

He is a dedicated medical laboratory technician with a strong passion for diagnostic health services. He graduated as the best student in medical laboratory technology from Mengo Hospital School of Medical Laboratory Technology in 2023, showcasing his commitment to excellence. Born into a humble family in Nebbi District, he is the firstborn of three children and values his leadership role. His parents are Mr. Unen Coothembu Fred and Mrs. Ojerra Milly from Pulum Jupudeba, Achana Sub-county. Aramalo is driven by a desire to advance medical research and laboratory medicine. He upholds integrity, community service, and continuous learning, striving to make a positive impact in both his field and society.

Mirriam Akullo , Mengo Hospital Medical Laboratory Training School

She is a Medical Laboratory Technologist and tutor with over 10 years of experience in clinical diagnostics and laboratory management. She has spent seven years as a tutor at Mengo Hospital Training School, teaching subjects like Medical Parasitology, Haematology, Medical Microbiology, and Laboratory Management. Mirriam holds a Master of Science in Immunology and Clinical Microbiology, a Post Graduate Diploma in Medical Education, and a Bachelor’s degree in Biomedical Laboratory Technology from Makerere University, along with a National Diploma in Medical Laboratory Technology. She is registered with the Allied Health Professional Council of Uganda. Throughout her career, Mirriam has worked in medical laboratories, conducted tests, trained students, and supervised research. She is passionate about clinical research and mentoring students to foster their professional development. She has also contributed to examining students under Uganda Allied Health examinations and preparing them for professional careers. Mirriam can be reached at Mengo Hospital Training School, P.O. Box 7161, Kampala, or via email at mirriamakullo@gmail.com, and phone at 0706-715017.

Benjamin Wathum Oromcan , Mengo Hospital Medical Laboratory Training School

He is a native of Zombo district in the north West Nile region of Uganda, and an Alur by tribe, born in 1972. He is a Biomedical Laboratory Scientist and Health Educator, currently serving as the Dean School of Allied Health Sciences and also works as the Principal of Mengo Hospital Medical Laboratory Training School. With over two decades of experience in medical laboratory sciences and health training, he is known for his strong communication, leadership, and organizational skills. He is passionate about teaching, mentoring, and helping others achieve their dreams while maintaining professionalism and Good Laboratory Practices (GLP). Oromcan thrives under pressure, embraces challenges, and is committed to delivering high-quality client service in a diverse work environment. Can be reached on uromcan@gmail.com; oromcan@mengohospital.org; Orcid id: https://orcid.org/0009-0007-2462-5637

References

Abongomera, G., Koller, M., Musaazi, J., Lamorde, M., Kaelin, M., Castelnuovo, B., Tasimwa, H. B., Eberhard, N., Hongler, J., Haller, S., Kambugu, A., & Fehr, J. (2021). The spectrum of antibiotic resistance in UTI caused by Escherichia coli among HIV-infected patients in Uganda. BMC Infectious Diseases, 7 pages. https://doi.org/https://doi.org/10.1186/s12879-021-06865-3

Adane, B., Tamirat, M., & Meseret, C. (2017). Species distribution and antibiotic susceptibility profile of bacterial uropathogens among patients complaining of urinary tract infections. BMC Infectious Diseases, 8 pages. https://doi.org/ 10.1186/s12879-017-2743-8

Chisanga, J., Mazaba, M., Mufunda, J., Besa, C., Kapambwe-muchemwa, M., & Siziya, S. (2017). Antimicrobial susceptibility patterns and their correlation for urinary tract infection pathogens at Kitwe Central Hospital, Zambia. 10 pages.

Desie, K., Blen, D., Mihret, A., Sosina, T., Dureti, D., Beimnet, A., Micheal, G., Sirak, B., & Habtamu, W. B. (2022, April 11). Antimicrobial resistance trend of bacterial uropathogens at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia. PLOS ONE, 13 pages. https://doi.org/ https://doi.org/10.1371/journal.pone.0266878

Félix, C. C., John, J. A.-C., Juan, C. G., Jaime, E. M., David, R. B., & Ramón, P.-T. (2022, April 8). Urinary Tract Infection and Antimicrobial Susceptibility of Bacterial Isolates in Saint Joseph Kitgum Hospital, Kitgum, Uganda. MPDP, 9 pages. https://doi.org/ https://doi.org/10.3390/

Ganesh, R., Shrestha, D., & Rai, G. (2019). Epidemiology of urinary tract infection and antimicrobial resistance in a pediatric hospital in Nepal. BMC infectious diseases, 5 pages.

George, A., Maurice, K., Joseph, M., Mohammed, L., Marisa, K., Barbara, C., Hannington, B. T., Nadia, E., Jan, H., Sabine, H., Andrew, K., & Jan, F. (2021). The spectrum of antibiotic resistance in UTI caused by Escherichia coli among HIV-infected patients in Uganda. BMC Infectious Diseases, 7 pages. https://doi.org/https://doi.org/10.1186/s12879-021-06865-3

Legese, C., Korinan, F., Temesgen, M., & Tsegaye, M. (2022, january 15). Bacterial profile and antimicrobial resistance patterns of common bacteria among pregnant women with bacteriuria in Ethiopia: Archives of Gynecology and Obstetrics (2022) 306:663–686, 24 pages. https://doi.org/10.1007/s00404-021-06365-4

Malyun, A. M., Omar, A., Fatima, A. H., & Sa’adia, A. K. (2020, February 18). Antibiotic resistance pattern of Escherichia coli isolates from outpatients with urinary tract infections in Somalia. The Journal of Infection in Developing Countries, 6 pages. https://doi.org/10.3855/jidc.12189

MoH-Uganda. (2015). Antimicrobial Resistance National Action Plan 2018- 2023. Kampala.

Munyemana, J. B., Bikorimana, J., Kantarama, E., & Kabanyana, P. (2020). Urinary tract infection and antimicrobial resistance profile in patients attending Nemba District Hospital in Rwanda. ASIAN JOURNAL OF MEDICAL SCIENCES, 5 pages.

Nduta, K., Sandra, T. G., Oluwatosin, O. A., Chloe, T., Eva, M. K., Sara, Y., & Agbaje, G. O. (2022, August 25). Scoping Review of National Antimicrobial Stewardship Activities in Eight African Countries and Adaptable Recommendations. MDPI, 17 pages. https://doi.org/https://doi.org/10.3390/antibiotics1109114

Odoki, M., Aliero, A. A., Tibyangye, J., Maniga, J. N., Wampande, E., Kato, C. D., & Bazira, J. (2019, February 17). Prevalence of Bacterial Urinary Tract Infections and Associated Factors among Patients Attending Hospitals in Bushenyi District, Uganda. International Journal of Microbiology, 2019, 8 pages.

Răzvan-Cosmin, P., Răzvan-Ionuț, P., Cristian, M., Aida, P., Claudia, M., Iulia, S., & Nicoleta, M. (2019). Antibiotic Resistance Profile of Common Uropathogens Implicated In Urinary Tract Infections In Romania. Farmacia, Vol. 67, 6, 11 pages. https://doi.org/https://doi.org/10.31925/farmacia.2019.6.9

Sanjida, K. S., Dr. Abu, N. I., Ahmed, A. S., Chandan, K. R., Mushtaque, A., Sikder, M., & Md, H. K. (2015, September 25). Bangladesh, Study of Bacterial pathogens in Urinary Tract Infection and their antibiotic resistance profile in a tertiary care hospital of Bangladesh. Bangladesh J Med Microbiol 2016, 5 pages.

Shakya, S., Edwards, J., Gupte, H. A., Shrestha, S., Shakya, B. M., Parajuli, K., Shrestha, P. S., Ghimire, R., & Thekkur, P. (2021, June 10). High multidrug resistance in urinary tract infections in a tertiary hospital, Kathmandu, Nepal. AMR PHA SUPPLEMENT, 21 pages. http://dx.doi.org/10.5588/pha.21.0035

WHO. (2021, November 17). Antimicrobial resistance.

Xiaorong, Y., Hui, C., Yue, Z., Sifeng, Q., Hao, W., & Fan, Y. (2022, July 27). Disease burden and long term trends of urinary tract infections: A worldwide report. Frontiers in Public Health, 13 pages. https://doi.org/10.3389/fpubh.2022.888205

Zuleica, N. T., Renata, K. K., Evelyn, P. C., Juliana, B. D., Luis, F. P., Eliana, C. V., & Wander, R. P. (2022, May 1). Susceptibility to first choice antimicrobial treatment for urinary tract infections to Escherichia coli isolates from women urine samples in community South Brazil. The Brazilian Journal of INFECTIOUS DISEASES, 7 pages. www. El s e vi e r. c om /l o c a t e / b ji d