Antibiotic Resistance Pattern of Uropathogens in a Tertiary Care Hospital in Calabar, Nigeria

Abstract

Introduction: Urinary tract infection is a major reason for hospital visits and a common clinical condition encountered by clinicians. The causative agents of urinary tract infection and their resistant pattern vary globally. The aim of this study was to highlight the profile of pathogens associated with urinary tract infections in our locality. The objective was to investigate the resistant pattern of these microbial isolates from patients with urinary tract infection and offer recommendations for effective treatment. Materials and methods: We retrospectively analyzed the urine culture and antimicrobial sensitivity reports of patients with suspected urinary tract infection at the University of Calabar Teaching Hospital, Calabar, Nigeria, from September 2019 to August 2020. Methicillin resistance was detected by disk diffusion method using 30 µg cefoxitin disk. Production of Extended spectrum beta lactamases was detected by the Combination disk and the double-disk synergy method. Results: Of 979 urine culture and sensitivity reports, 306 (31.26%) were positive for microbial growth. Two microbial isolates each were recovered from urine samples of 5 patients giving a total number of 311 isolates from 306 patients. 45.75% of positive results were in males. The predominant isolate was Escherichia coli (n=97, 31.19%). Extended Spectrum Beta Lactamases (ESBL) producing strains comprised 10.08% (10/238) of Gram-negative group of organisms, while 47.39% (145/306) of all bacterial isolates in our study were multi drug resistant (MDR). 14.29% (6/42) of S. aureus isolates were methicillin resistant S. aureus, while 33.33% (2/6) of methicillin resistant S. aureus (MRSA) were multi drug resistant. Conclusion: Urinary tract infection caused by antimicrobial resistant organisms is common among studied patients. This emphasizes the need for urine culture and sensitivity tests in the management of urinary tract infection.