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Mareș C, Petca RC, Popescu RI, Petca A, Mulțescu R, Bulai CA, Ene CV, Geavlete PA, Geavlete BF, Jinga V. Update on Urinary Tract Infection Antibiotic Resistance-A Retrospective Study in Females in Conjunction with Clinical Data. Life (Basel) 2024; 14:106. [PMID: 38255721 PMCID: PMC10820678 DOI: 10.3390/life14010106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Urinary tract infections (UTIs) represent a frequent pathology among the female population that has become more and more difficult to treat in the past decade, considering the increase in antibiotic resistance-a serious global public health problem. A cross-sectional retrospective study was conducted for six months to report an update regarding the rates of resistance and susceptibility of uropathogens necessary for optimal treatment. A total of 5487 patients were screened, of which 524 (9.54%) were female patients who met the criteria for inclusion in the study. Escherichia coli was the most common pathogen, representing 290 cases (55.34%), followed by Enterococcus spp. 82 (15.64%). Escherichia coli presented the highest resistance to amoxicillin-clavulanic acid (R = 33.1%), followed by trimethoprim-sulfamethoxazole (R = 32.41%) and levofloxacin (R = 32.06%). The highest sensitivity rates were observed for fosfomycin (S = 96.55%), followed by imipenem (S = 93.1%). Enterococcus spp. showed the highest resistance to levofloxacin (R = 50.0%), followed by penicillin (R = 39.02%). The highest sensitivity was observed for fosfomycin (S = 90.24%), linezolid (S = 89.02%), and nitrofurantoin (S = 86.58%). The second most frequent Gram-negative uropathogen was represented by Klebsiella spp., which had the highest resistance to amoxicillin-clavulanic acid (R = 35.89%), followed by levofloxacin (R = 25.64) and trimethoprim-suflamethoxazole (R = 24.35%). The most frequently associated pathology was an episode of UTI in the previous year, followed by diabetes and chronic kidney disease. Antibiotic resistance is a serious problem for all clinicians who treat UTIs. An up-to-date knowledge of antibiotic resistance rates is a major necessity to stop its evolution. Overall, the highest resistance rates were observed for aminopenicillins, fluoroquinolones, and trimethoprim-sulfamethoxazole. The best susceptibility rates were observed for fosfomycin, nitrofurantoin, and carbapenems. Our report aims to guide clinicians whenever they are forced to prescribe antibiotics empirically.
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Affiliation(s)
- Cristian Mareș
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Răzvan-Cosmin Petca
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania
| | - Răzvan-Ionuț Popescu
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania
| | - Aida Petca
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Elias University Emergency Hospital, 17 Mărăști Blvd., 050474 Bucharest, Romania
| | - Răzvan Mulțescu
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Cătălin Andrei Bulai
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Cosmin Victor Ene
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Petrișor Aurelian Geavlete
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Bogdan Florin Geavlete
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Viorel Jinga
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania
- Medical Sciences Section, Academy of Romanian Scientists, 050085 Bucharest, Romania
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Ezo E, Binora H, Solomon F, Zekiwos A, Mezgebu T, Admasu S, Birhanu B. Risk Factors and Prevalence of Urinary Tract Infection among Pregnant Women Attending Antenatal Care at Wachemo University Comprehensive Specialized Hospital. SAGE Open Nurs 2024; 10:23779608241264172. [PMID: 38895654 PMCID: PMC11185033 DOI: 10.1177/23779608241264172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/02/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024] Open
Abstract
Background Urinary tract infection is the single most common bacterial infection of mankind. Objective To assess the risk factors and prevalence of Urinary tract infection among pregnant women attending antenatal care at Wachemo University Comprehensive Specialized Hospital, Central Ethiopia, 2023. Methods An institutional-based cross-sectional study design was conducted from 2 October to 29 December 2023. The total sample size was 405 and a systematic random sampling technique was used. Data were entered using the Epi-data 3.1 version and exported to SPSS 25 for analysis. Multicollinearity was checked. The goodness of fit test was done using the Hosmer-Lemeshow goodness of fit test. Binary logistic regression analysis was done, and variables with a p-value of <0.25 in the bivariable analysis were taken into the multivariable analysis. Statistical significance was declared at a p-value of <0.05 with an adjusted odds ratio and 95% confidence interval. Result The prevalence of urinary tract infection was 40.7% with 95%CI [36.5-45.2]. Rural resident [AOR: 2.32, 95% CI: 1.36-3.96], educational status of husband no formal education [AOR: 3.38, 95% CI: 1.24-9.21], educational status of husband primary level [AOR: 2.94, 95% CI: 1.06-8.18], having vaginal bleeding [AOR: 3.89, 95%CI: 1.78-8.47], having female genital mutation [AOR: 2.98, 95%CI: 1.83-4.84], itchiness around genitalia [AOR: 3.82, 95%CI: 1.14-12.82], and using water for cleaning after defecation [AOR: 0.46, 95%CI: 0.22-0.97] were significantly associated. Conclusion Four in ten pregnant women attending antenatal care had urinary tract infections. Residence, educational status of the husband, vaginal bleeding, female genital mutation, itchiness around genitalia, and mode of cleaning after defecation were significantly associated. Therefore, creating awareness for rural women, improving the educational status of husbands`, treatment of vaginal bleeding, avoiding female genital mutation, screening and treating itchiness around genitalia, and using water for cleaning after defecation might reduce the burden.
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Affiliation(s)
- Elias Ezo
- Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Hirut Binora
- Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Fraol Solomon
- Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Asnakech Zekiwos
- Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Taye Mezgebu
- Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Senteyehu Admasu
- Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Bethelhem Birhanu
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
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Gebretensaie Y, Atnafu A, Alemu Y, Girma S, Desta K. Evaluation of the Diagnostic Performance of the LINEAR Cromatest and Laboquick URS 10-T Dipsticks Among Urinary Tract Infection Suspects in Addis Ababa, Ethiopia: A Cross-Sectional Study. Res Rep Urol 2023; 15:437-445. [PMID: 37818231 PMCID: PMC10560765 DOI: 10.2147/rru.s434128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023] Open
Abstract
Background Urinary tract infections (UTIs) bring a significant and serious health-related problem. Repeated infections may lead to the development of renal scarring and end-stage renal dysfunction. Therefore, balancing the choices of UTI diagnostic tools depending on the costs versus accuracy can minimize false results that may subject patients to wrong treatments. Objective The objective of the study was to evaluate the diagnostic performance of LINEAR cromatest and Laboquick URS 10-T dipsticks against conventional urine culture at Arsho Advanced Medical Laboratory (AAML), Addis Ababa, Ethiopia. Methods A similar cohort of UTI-suspected patients from our previous study, who were prospectively enrolled from Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia, were considered for this analysis. Data analysis was performed using SPSS version 26. The sensitivity, specificity, and predictive value of different dipsticks were calculated using culture as a gold standard. ROC curve analysis was also used to determine diagnostic performance. A test with a P-value of <0.05 was considered statistically significant. Results Out of 446 urine samples processed, bacterial growth was observed in 141 (31.6%). Of this figure, 105/141 (74.5%) and 36/141 (25.5%) were from female and male participants, respectively. The sensitivity and specificity of the LINEAR Cromatest dipstick were 83.7% and 67.9%, respectively (P-value <0.001). The Laboquick URS 10-T dipstick showed sensitivity and specificity of 87.9% and 68.5%, respectively (P-value <0.001). The ROC analysis showed an AUC of >0.7 for both dipsticks. Conclusion In a setting where there is no access to urine culture, the urine dipstick may be considered an alternative diagnostic tool in the diagnosis of UTIs.
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Affiliation(s)
- Yosef Gebretensaie
- American Advanced Medical Laboratory, American Medical Center, Addis Ababa, Ethiopia
| | - Abay Atnafu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Yonas Alemu
- Department of Microbiology, Immunology, and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Selfu Girma
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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