Infection and Drug Resistance (Apr 2023)

Community-Acquired Urinary Tract Infection Among Sexually Active Women: Risk Factors, Bacterial Profile and Their Antimicrobial Susceptibility Patterns, Arba Minch, Southern Ethiopia

  • Seid M,
  • Markos M,
  • Aklilu A,
  • Manilal A,
  • Zakir A,
  • Kebede T,
  • Kulayta K,
  • Endashaw G

Journal volume & issue
Vol. Volume 16
pp. 2297 – 2310

Abstract

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Mohammed Seid,1 Mesafint Markos,1 Addis Aklilu,1 Aseer Manilal,1 Abdurezak Zakir,1 Teshome Kebede,2 Kebede Kulayta,3 Gessila Endashaw4 1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 2Arba Minch General Hospital, Arba Minch, Ethiopia; 3Department of Medical Laboratory Science, Arba Minch College of Health Sciences, Arba Minch, Ethiopia; 4Department of Nursing, Arba Minch University, Arba Minch College of Health Sciences, Arba Minch, EthiopiaCorrespondence: Mohammed Seid, Email [email protected]: Globally, urinary tract infections (UTIs) are a common health issue among women. Investigating risk factors associated with culture-proven UTIs and the antimicrobial resistance profile of uropathogens would provide insight into planning prevention and control measures.Objective: To identify the risk factors associated with UTIs among sexually active women and determine antimicrobial susceptibility patterns of uropathogenic bacterial isolates.Methods: A case-control study was conducted from February to June 2021, involving 296 women (62 case group and 234 control group in a ratio of 4:1). Cases were defined as culture-confirmed UTIs, and controls were non-UTIs. A semi-structured questionnaire was used to collect demographic, clinical, and behavioral data. The antimicrobial susceptibility test was done by the Kirby-Bauer disc diffusion method. The data were analyzed using SPSS version 25. Bivariable and multivariable logistic regressions were used to identify risk factors, and the strength of association was measured by adjusted odds ratios and a 95% confidence interval used at P-values < 0.05.Results: The results revealed that recent coitus and frequency of coitus more than three times per week (P=0.001) were independent predictors of UTIs. Swabbing from back to front, a history of UTI and a delay in voiding were also independent predictors (P < 0.05). On the other hand, a daily water intake of 1 to 2 litres reduced the risk of UTI (P= 0.001). The predominant uropathogenic isolate was Escherichia coli (35.48%). Over 60% of isolates were resistant to cotrimoxazole, penicillin, cephalosporin, and fluoroquinolones. The most effective antibiotics included piperacillin-tazobactam, aminoglycosides, carbapenem, and nitrofurantoin. 85% and 50% of isolates were MDR and ESBL producers, respectively.Conclusion: The finding indicates the importance of public intervention targeting the identified risk factors and the resistance phenotype to reduce the burden of UTIs with antimicrobial resistance in the study area.Keywords: risk factors, adolescents and young women, bacteriuria, symptomatic UTIs, uropathogens, antimicrobial resistance, ESBL producing, case-control, Ethiopia

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