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Community acquired urinary tract infections among adults in Accra, Ghana

Background: Urinary tract infection (UTI) is one of the most common bacterial infectious diseases encountered in clinical practice, and accounts for significant morbidity and high medical costs. To reduce its public health burden, there is the need for local research data to address aspects of preve...

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Autores principales: Donkor, Eric S, Horlortu, Prince Z, Dayie, Nicholas TKD, Obeng-Nkrumah, Noah, Labi, Appiah-Korang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628945/
https://www.ncbi.nlm.nih.gov/pubmed/31372013
http://dx.doi.org/10.2147/IDR.S204880
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author Donkor, Eric S
Horlortu, Prince Z
Dayie, Nicholas TKD
Obeng-Nkrumah, Noah
Labi, Appiah-Korang
author_facet Donkor, Eric S
Horlortu, Prince Z
Dayie, Nicholas TKD
Obeng-Nkrumah, Noah
Labi, Appiah-Korang
author_sort Donkor, Eric S
collection PubMed
description Background: Urinary tract infection (UTI) is one of the most common bacterial infectious diseases encountered in clinical practice, and accounts for significant morbidity and high medical costs. To reduce its public health burden, there is the need for local research data to address aspects of prevention and management of UTI. The aim of this study was to investigate community-acquired UTI among adults in Accra, Ghana, including the risk factors, etiological agents, and antibiotic resistance. Methods: This was a cross-sectional study involving 307 patients clinically diagnosed with UTI at the Korle Bu and Mamprobi polyclinics in Accra. Urine specimens were collected from the study participants and analyzed by culture, microscopy, and dipstick. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antibiotics by the Kirby Bauer method. Multidrug resistant Enterobacteriaceae isolates were screened for Extended Spectrum β-lactamase (ESBL) production by the double disc method, and isolates that tested positive were analyzed by Polymerase Chain Reaction for ESBL genes. Demographic information and clinical history of study participants were collected. Results: Based on the criteria for laboratory confirmed UTI, 31 (10.1%) of the 307 specimens were positive and the main risk factor of UTI among the study participants was pregnancy (P=0.02, OR=2.43). The most common uropathogen isolated was Escherichia coli (48.9%), followed by Klebseilla sp. (16.1%). Prevalence of resistance was highest for Piperacillin (87.1%) and Amoxicillin+Clavulanic Acid (87.1%) and lowest for Amikacin (12.9%). Prevalence of multidrug resistance among the uropathogens was 80.1% (25) and the most common ESBL gene detected was CTX-M-15. Conclusion: Pregnant women constitute the key risk population of UTI in Accra, while Amikacin remains a suitable drug for the treatment of febrile UTI. The high prevalence of multidrug resistance among the uropathogens highlights the need for surveillance of antimicrobial resistance among these pathogens.
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spelling pubmed-66289452019-08-01 Community acquired urinary tract infections among adults in Accra, Ghana Donkor, Eric S Horlortu, Prince Z Dayie, Nicholas TKD Obeng-Nkrumah, Noah Labi, Appiah-Korang Infect Drug Resist Original Research Background: Urinary tract infection (UTI) is one of the most common bacterial infectious diseases encountered in clinical practice, and accounts for significant morbidity and high medical costs. To reduce its public health burden, there is the need for local research data to address aspects of prevention and management of UTI. The aim of this study was to investigate community-acquired UTI among adults in Accra, Ghana, including the risk factors, etiological agents, and antibiotic resistance. Methods: This was a cross-sectional study involving 307 patients clinically diagnosed with UTI at the Korle Bu and Mamprobi polyclinics in Accra. Urine specimens were collected from the study participants and analyzed by culture, microscopy, and dipstick. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antibiotics by the Kirby Bauer method. Multidrug resistant Enterobacteriaceae isolates were screened for Extended Spectrum β-lactamase (ESBL) production by the double disc method, and isolates that tested positive were analyzed by Polymerase Chain Reaction for ESBL genes. Demographic information and clinical history of study participants were collected. Results: Based on the criteria for laboratory confirmed UTI, 31 (10.1%) of the 307 specimens were positive and the main risk factor of UTI among the study participants was pregnancy (P=0.02, OR=2.43). The most common uropathogen isolated was Escherichia coli (48.9%), followed by Klebseilla sp. (16.1%). Prevalence of resistance was highest for Piperacillin (87.1%) and Amoxicillin+Clavulanic Acid (87.1%) and lowest for Amikacin (12.9%). Prevalence of multidrug resistance among the uropathogens was 80.1% (25) and the most common ESBL gene detected was CTX-M-15. Conclusion: Pregnant women constitute the key risk population of UTI in Accra, while Amikacin remains a suitable drug for the treatment of febrile UTI. The high prevalence of multidrug resistance among the uropathogens highlights the need for surveillance of antimicrobial resistance among these pathogens. Dove 2019-07-11 /pmc/articles/PMC6628945/ /pubmed/31372013 http://dx.doi.org/10.2147/IDR.S204880 Text en © 2019 Donkor et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Donkor, Eric S
Horlortu, Prince Z
Dayie, Nicholas TKD
Obeng-Nkrumah, Noah
Labi, Appiah-Korang
Community acquired urinary tract infections among adults in Accra, Ghana
title Community acquired urinary tract infections among adults in Accra, Ghana
title_full Community acquired urinary tract infections among adults in Accra, Ghana
title_fullStr Community acquired urinary tract infections among adults in Accra, Ghana
title_full_unstemmed Community acquired urinary tract infections among adults in Accra, Ghana
title_short Community acquired urinary tract infections among adults in Accra, Ghana
title_sort community acquired urinary tract infections among adults in accra, ghana
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628945/
https://www.ncbi.nlm.nih.gov/pubmed/31372013
http://dx.doi.org/10.2147/IDR.S204880
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