Antibiotic Resistance Pattern Of Uropathogenic Escherichia Coli And Risk Factors Associated With Urinary Tract Infections Among Human Immunodeficiency Virus Seropositive Patients Attending Itojo Hospital
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Date
2023
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Kampala International University
Abstract
Introduction and back ground: Urinary tract infections (UTIs) are caused by invasion and multiplication of micro-organisms in the organs of the urinary tract system (Dadi Marami et al., 2019). Human immunodeficiency virus infection is one of the major comorbidities that cause serious health related challenges in a population that harbour this virus. HIV infects and kills essential immune system cells in the body, including helper T cells (particularly CD4+ T cells), macrophages, and dendritic cells This predisposes this population to increased risks of getting opportunistic infections including urinary tract infections (Haile Hantalo et al 2020). Objectives of the study: Antibiotic resistance pattern of uropathogenic Escherichia coli and risk factors associated with urinary tract infections among human immunodeficiency virus seropositive patients attending Itojo hospital Materials and methods:A total of 333 urine samples were bacteriologically analyzed for the isolation and characterization of uropathogenic of E. coli using standard microbiology techniques. Results: Of the 333 clean catch urine samples were collected and analyzed, 120 (36.0%) Samples yielded cultural growth, 34 (28.3%) of these were confirmed E.coli. Meropenem and levofloxacin antibiotics (79.4%) while exhibited high resistance to Nitofurantoin (100%), followed by resistance to gentamicin (94.1%). PCR amplification of DNA from all E. coli isolates (both ESBL producers and non-producers) showed the presence of BlaTEM gene (493 bp), BlaCTX-M genes (410 bp) and BlaSHV genes (214 bp). Out of 34 isolates genotyped for the presence of selected ESBL genes, highest occurrence of BlaTEM genes (70.6%) documented, followed by BlaCTX-M genes (52.9%), combination of BlaTEM and BlaCTX-M genes (41.2%) and least BlaSHV genes (5.9%). The study showed that level of education p value 0.035* was statistically significantly associated with the occurrence of uropathogenic E. coli among the studied HIV participants. It revealed that the level of education an associated risk factor for the prevalence of E. coli among the studied participants. Conclusion and recommendation: A prevalence of 28.3% uropathogenic E. coli was reported among Human Immunodeficiency Virus Seropositive Patients Attending Itojo Hospital. The study revealed that uropathogenic E. coli isolates were highly susceptible to meropenem and levofloxacin antibiotics (79.4%) while exhibited high resistance to Nitofurantoin (100%), followed by resistance to gentamicin (94.1%). Majority of the isolates (76.5%) were phenotypically ESBL producers. There is need for increased surveillance for prompt detection of MDR UPEC in our hospitals and hospital laboratories to ensure guided therapeutic management for proper prognosis of our patients.