Prevalence And Susceptibility Of Uropathogens Causing Urinary Tract Infections In Patients Presenting At Masvingo General Hospital

ABSTRACT

Urinary Tract Infections (UTIs) are a serious problem globally and are some of the most

common diseases encountered in medical practice today. Despite the widespread availability

of antibiotics, UTIs remain a problem because of antimicrobial resistance. Antimicrobial

susceptibility testing therefore provides information that allows physicians to select the most

appropriate antibiotics for UTIs. This study was carried out to: (i) determine the prevalence

of UTIs among patients presenting at Masvingo General Hospital, (ii) evaluate the sensitivity

patterns of the identified isolates, and (iii) determine the efficacy of eight commonly used

antibiotics (Ampicilin, Tetracycline, Nitrofurantion, Nalidixic acid, Gentamicin,

Ciprofloxacin, Kanamycin and Norfloxacin) against the isolates using Kirby Bauer disc

diffusion technique. A total of 123 urine samples were collected from patients seeking

treatment for UTIs Masvingo General Hospital. Sample processing and patient information

collection were carried out at Genau Pathology Laboratories in Masvingo. Urine samples

were analysed following standard microbiological techniques. The bacterial isolates

recovered were Escherichia coli, Klebsiella spp, Pseudomonas aureginosa and

Staphylococcus aureus. Of the 123 samples examined, 47 (38%) comprising of 36(77%)

females and 11(23%) males were positive for UTIs. The most common uropathogen was

Escherichia coli with a prevalence of 47%, followed by Staphylococcus aureus (21%),

Klebsiella spp (17%) and Pseudomonas aureginosa (13%). Antimicrobial susceptibility tests

showed that the most effective antibiotic was nitrofurantoin being effective against 79% of

the isolates, followed by gentamycin (66%) and kanamycin (66%). The least effective

antibiotic was ampicillin, which was effective against only 4 out of 47 (9%) isolates,

followed by nalidixic acid, effective against 19 out of 47 (40%) of the isolates. Escherichia

coli was highly resistant to ampicillin but highly sensitive to nitrofurantoin. Klebsiella

species were highly resistant to Ampicillin but highly sensitive to Kanamycin. Pseudomonas

aureginosa was totally resistant to ampicillin but four drugs were effective against it, namely,

nitrofurantoin, tetracyclin, ciprofloxacin and norfloxacin. Lastly, Staphylococcus aureus was

resistant to nalidixic acid and ampicillin but highly sensitive to nitrofurantoin. Overall, the

results suggest that the most common uropathogen causing UTIs in patients presenting at

Masvingo General Hospital was Escherichia coli and most isolates were resistant to

ampicillin and nalidixic acid but highly sensitive to nitrofurantoin, gentamycin and

kanamycin. Therefore nitrofurantoin, gentamycin and kanamycin are recommended for

treatment against UTIs. The relatively high prevalence (38%) of UTIs at Masvingo General

Hospital suggests that UTIs are a risk to people around Masvingo Province thus there is need

to monitor the profile of etiological bacteria of UTIs and the antimicrobial resistance

regularly. This would show emergence of resistance to newer therapeutic agents as well as

keep track of effectiveness of serving therapeutic agents.