Bacterial Profiles and Their Associated Factors of Urinary Tract Infection and Detection of Extended Spectrum Beta-Lactamase Producing Gram-Negative Uropathogens Among Patients with Diabetes Mellitus at Dessie Referral Hospital, Northeastern Ethiopia

Abstract

Mekuanent Alemu,1 Melaku Ashagrie Belete,2 Solomon Gebreselassie,3 Assefa Belay,1 Daniel Gebretsadik2 1Department of Medical Laboratory Science, Dessie Health Science College, Dessie 1212, Amhara, Ethiopia; 2Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia; 3Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa 1176, EthiopiaCorrespondence: Melaku Ashagrie BeleteDepartment of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie 1145, EthiopiaTel [phone]Fax [phone]Email [email protected]: To determine the bacterial profile with its associated risk factors and to identify extended spectrum beta-lactamase producing Gram-negative bacterial uropathogens among diabetic patients at Dessie Referral Hospital, Northeastern Ethiopia.Materials and Methods: A hospital-based cross-sectional study was conducted from May to September 2018. A total of 336 diabetic patients were included using a simple random sampling technique. A structured questionnaire was used to collect socio-demographic and risk factor-related data. A 10-mL mid-stream urine specimen was collected and transported to the microbiology laboratory for culture, antimicrobial susceptibility testing, and detection of ESBL-producing bacteria. The data were entered into SPSS version 22, and descriptive statistics, bivariate and multivariate logistic regression analyses were performed. A p-value ≤ 0.05 with a 95% confidence interval was considered for statistical significance.Results: Among 336 diabetic patients, the overall prevalence of UTI was 11.6%. The predominant bacterial isolate was Escherichia coli 12/39 (30.8%), followed by Klebsiella pneumoniae 11/39 (28.2%) and coagulase-negative staphylococci 7/39 (17.9%). Gram-negative isolates showed 100% resistance to ampicillin, whereas Gram-positive isolates showed a high level of resistance to penicillin and tetracycline. Moreover, MDR was observed among 18 (46.2%) of the isolates and 2 of the isolated Gram-negative bacteria were ESBL producers. Being illiterate (AOR=7.226, 95% CI: (1.478, 35.340), p< 0.015), having current symptoms of UTI (AOR = 2.702, 95% CI: (1.102, 6.624), p=0.030), and blood glucose level ≥ 126 mg/dl (AOR = 2.940, 95% CI: (1.080, 8.005), p=0.035) were significantly associated with the occurrence of bacterial UTI.Conclusion: The overall prevalence of significant bacteriuria (11.6%) in this study was comparable with some studies in Ethiopia and relatively lower than others. A moderately higher rate of resistance to the commonly used antimicrobial agents was noticed for both Gram-negative and Gram-positive isolates. Health information dissemination should be given about UTI, glycemic control, and habit of drug use for diabetes mellitus patients.Keywords: urinary tract infection, diabetes mellitus, bacterial profile, antimicrobial susceptibility pattern, risk factors, ESBL

Keywords

• urinary tract infection
• diabetes mellitus
• bacterial profile
• antimicrobial susceptibility pattern
• risk factors
• esbl.