Patterns of urinary tract infections (UTIS) in a South African Public Hospital
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Date
2021
Authors
Jaji, Benhilda
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Abstract
Introduction: Urinary tract infections (UTIs) are amongst the most common types of
bacterial infection in public hospitals and the second most common reason for
empirical antibiotic treatment. Optimal treatment could decrease morbidity and
mortality in women, also battling the ongoing crises of increasing antibiotic resistance.
The aim of this study was to determine antimicrobial resistance patterns of UTIs in the
study hospital, in order to recommend an effective treatment protocol and infection
management practices.
Method: This study was conducted on 200 urine samples collected from outpatient
departments of the study hospital. The antimicrobial susceptibility patterns of isolated
bacteria were determined by disk diffusion method (Kirby–Bauer). Bacterial isolates
were identified using the MicroScan.
Results: A total of 238 bacterial isolates were found in uncomplicated UTIs. Among
them, the most predominant bacteria were Escherichia coli (43.6%). A total of 194
bacterial isolates were found in complicated UTIs, where similarly E. coli (31.2%) was
the most predominant bacteria encountered. Antibiotic susceptibility patterns showed
that almost all of the isolates were resistant to at least one antibiotic. Highest
resistance percentage of the isolates in uncomplicated UTIs was observed in
cephalexin (96.2%) followed by co-trimoxazole (91.3%). Highest resistance
percentage of the isolates in complicated UTIs was observed in cephalexin and co trimoxazole (100%).
Conclusion: This study provides evidence for an updated treatment protocol, hence,
providing valuable tools for antimicrobial stewardship in South Africa. Knowing the
resistance levels is key to effective and cost-effective empirical prescribing. Co trimoxazole resistance rates are 100%, in which case a single 3 g dose of fosfomycin
is likely to be the most cost-effective treatment option
Description
A dissertation submitted in fulfilment of the requirements for the degree of Master of Pharmacy to the Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, 2021