Prevalence, Antimicrobial Resistance, and Risk Factors for Urinary Tract Infections among Outpatients at the Regional Annex Hospital of Dschang, Cameroon

Abstract

Aims: To determine the prevalence, risk factors and antimicrobial profile of uropathogens among outpatients suspected of urinary tract infections (UTI) at the Regional Annex Hospital of Dschang. Study Design: A cross-sectional study was conducted from April to June 2023 among outpatients who sought consultation for a urinary infection at the Regional Annex Hospital of Dschang Methodology:  We included 173 patients suspected to have UTI. Clean catch mid-stream non-duplicated urine samples were collected observed macroscopically, subjected to microscopy, cultured on Cystine Lactose Electrolyte Deficient Agar (CLED). Gram-negative bacteria were identified using Enterosystem 18R kit following the manufacturer's instructions while Gram-positive were identified using a battery of biochemical tests. Antibiotic susceptibility testing was performed using the disk diffusion method. Data analysis was performed using Excel 2016 and SPSS version 22.0, P≤0.05 was considered significant. Results: A total of 173 non-duplicated urine samples were collected from 173 patients and analyzed during the period of this study. Majority of the participants were females 91.3% (158/173). The prevalence of UTI was found to be 49.71% (86/173), and the most frequently isolated bacteria were E. coli (38.37%), Klebsiella spp. (20.93%), and Staphylococcus spp. (16.27%). Gram-negative bacteria and Staphylococcus spp showed higher resistance patterns, particularly to β-lactam antibiotics. In total, 38.37% of the isolates were multidrug-resistant. Factors such as age (OR:3.355; P:0.305), fever (OR:3.216; P:0.013), Douching with detergents (OR:5.326; P:0.05), interruption of antibiotic treatment (OR:9.167; P:0.026) and used of oral contraceptives (OR:4.500; P:0.036) were found to be strongly associated with UTI infections. Conclusion: Overall, this study indicates a high prevalence of bacterial urinary tract infections, as well as a high level of resistance patterns to β-lactamines and several risk factors associated with UTI in our area.