Antibiotic susceptibility patterns of bacterial uropathogens at a private tertiary hospital in Uganda: a...

Urinary tract infections are disproportionately prevalent in low- and middle-income countries, where a significant portion of the population relies on over the counter and self-prescriptions to manage symptoms. This practice has contributed to a concerning shift in antimicrobial resistance trends, among the most recommended treatments.

A cross-sectional retrospective study was conducted at Mengo Hospital's medical laboratory, utilizing data from the hospital management system between January 2019 and July 2023. A total of 1,091 urine samples were collected and cultured on Cysteine Lactose Electrolyte Deficient agar. Of the samples analyzed, 476 showed significant bacteria growth (> 10⁵ colony-forming units). Organisms were identified using Gram staining and other biochemical techniques. Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Data was entered into Microsoft Excel, cleaned, and analyzed using STATA 15.0.

Among the 476 records with bacterial growth, 74.8% were females. The highest incidence of infection occurred in individuals aged 50 years and above (31.7%). The most isolated bacterial organisms were Gram-negative Escherichia coli (39.5%) and Gram-positive Staphylococcus aureus (25.6%). E.coli was most isolated among females (78.2%, p < 0.0001). Imipenem (83.9%), amikacin (72%), and nitrofurantoin (65.5%) were the antimicrobial agents to which isolated bacteria exhibited the highest sensitivity. Conversely, bacteria showed highest resistance to ciprofloxacin and ofloxacin of 65.5% and 64.5%, respectively.

The increasing resistance of uropathogens to commonly prescribed and affordable antibiotics is a growing concern. Ciprofloxacin, a widely used empirical treatment, has shown a significant shift towards resistance, highlighting the need for healthcare facilities to utilize bacteriology laboratories for culture and antimicrobial susceptibility testing, and surveillance to inform standard treatment guidelines.