1Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, International University of Africa, Khartoum State, Sudan
2Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Elrazi University, Khartoum State, Sudan
3Faculty of Medicine, Nahda College, Khartoum, Sudan
Introduction: Urinary tract infection (UTI) is the presence of multiplying bacteria within the urinary tract with a threshold number of pathogenic bacteria (105 CFU/mL) in urine. Despite the presence of different host defense mechanisms against microbial infection in urinary tract [1].
Methodology: A retrospective record review of culture results of all types of wound swabs referred to this private major hospital from 1 June 2020 to 31 December 2020 was conducted. The hospital is considered one of the few hospitals in Khartoum that conduct microbiological procedures. This is a study based on bacteriological laboratory records review in which we have extracted a total of 134 urine culture reports using data extraction sheet. We considered all records documented during the stated time period.
Results: A total of 134 isolated organisms were considered pathogens from urine samples, 103 (77%) of which were multidrug resistant with a display of resistance to a minimum of four drugs most notably amoxiclav and cefepime. Gram negative representing the majority of isolated bacteria. E. coli was the most frequently isolated bacteria with 53; 44 (83%) of which were MDR, showing high level of resistance to amoxiclav (90%), cefepime (85%), piperacillin (86%) and co-trimoxazole (84%), a level of carbapenem resistance was also observed to aztreonam, imipenem and meropenem showing (69%), (12%) and (18%) respectively. The lowest resistance rate was observed with colistin (2%). K. pneumoniae appeared highly resistant to piperacillin (93%), amoxiclav (95%) and cefepime (83%), along with third generation cephalosporins ceftazidime and ceftriaxone (75%) and (65%) respectively. Carbapenem resistance was also present for meropenem (40%), imipenem (52%) and aztreonam (69%). With (10%) resistance rate to colistin; P. aeruginosa appeared multidrug resistant in 20 out of 22 isolates, the highest being against cefepime (100%), amoxiclav (88%), ceftriaxone (78%), piperacillin (73%) and ciprofloxacin (72%). Carbapenem resistance was observed to meropenem (53%), (46%) for imipenem and aztreonam (31%).
Conclusion: Out of the several isolated organism from UTI, 85% were gram negative and amongst them E. coli was the most common followed by K. pneumoniae and P. aeruginosa. A large number of those bacteria displayed MDR due to increasing use of antibiotics randomly and irrationally. The involvement of such amount of multidrug resistant bacteria in urinary tract infections is a very serious problem and should not be neglected. Serious steps should be taken by the authorities to improve or at least avoid the worsening of the situation with the hope that it’s not too late.
Keywords: Multidrug Resistance; E coli; K. pneumoniae; S. aureus; Antimicrobial Therapy; Urinary Tract Infections; Uropathogenic Bacteria
Khairy M Ali.,et al. Prevalence of Multidrug Resistant Uropathogenic Bacteria in a Major Hospital in Khartoum, Sudan. EC Pharmacology and Toxicology 11.1 (2023): 15-21.
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