Publication: Antibiogram patterns of uropathogenic Escherichia Coli and socio-demographic factors of patients attending Kericho County Hospital.
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2016-10
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Mount Kenya University
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Abstract
Escherichia coli is the common cause of primary urinary tract infections (UTIs). UTIs are the
most common non-intestinal infection in women worldwide. Antimicrobial susceptibility
testing provides information that allows physicians to select the 21 most appropriate
antimicrobial agents for treating a specific infection. A cross-sectional study was conducted
at Kericho County Hospital patient’s clinic between January and June 2015. A total of 133
urine samples were collected and used to investigate the prevalence of UTIs and to determine
the antimicrobial profile of extraintestinal E. coli clinical isolates among patients. UTIs were
diagnosed using mid-stream urine culture on standard media. The bacterial isolates recovered
were tested against trimethoprim-sulfamethoxazole, gentamycin, amikacin, ceftriaxone,
ciprofloxacin, cefoxitin, cefepim, imipenem, ampicillin and amoxicillin-clavulanic acid using
Kirby-Bauer disc diffusion technique. Data was entered in MS Excel spread sheet and
analyzed by using SPSS version 21. Among the 133 specimen examined 106 (79.7%) showed
significant bacterial growth. E.Coli was the most pre-dorminant 38 (35.8%), followed by
Staphylococcus aureus 31 (29.2%), Klebsiella pneumonia 18 (17%), Psedomonas aeruginosa
15 (14.2%) and Proteus mirabilis 4 (3.8%). Out of 38, Escherichia coli isolates 22 (58%)
from females and 16 (42%) from male. Approximetly 16 (73%) of the isolates were resistant
to trimethoprim-sulfamethoxazole and 20 (91%) resistant to amoxicillin clavulanic acid; 21
(96%) were susceptible to imipenem and 18 (82 %) amikacine. E. coli showed high
sensitivity to imipenem and amikacine but resistant to trimethoprin-sulfamethoxazole and
amoxicillin-clavunic acid. Chi-square analysis indicated no association between gender of
patient and pathogens isolate (p = 0.835). Out of 106 isolates, Escherichia coli was the most
prevalent clinical isolate (p value = 0.905) although there was 38 isolates, no association
between the age of patient and pathogens isolated in patients indicating a possibility of an
equal chance of being infected irrespective of age. Escherichia coli was the most prevalent
causative organism, showing multi drug resistance pattern. Considering the relatively high
rates of UTIs and drug resistance observed in this study, continued local, regional, and
national surveillance is warranted. Imipenem and amikacine should be considered as drug of
choice for empirical treatment of community acquired uncomplicated UTIs in patients in
Kericho County hospital.
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Escherichia coli, urinary tract infections, Klebsiella pneumonia, Kericho County