Antibiogram Profile of Extraintestinal Pathogenic Escherichia Coli Clinical Isolates From Patients with Urinary Tractinfections at Kericho District Hospital, Kenya

Abstract

Background: 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. Methods: A cross-sectional study was conducted at Kericho District Hospital in and out 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 in and out 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 20. Results: Among the 133 samples examined, 38% had E. coli isolates with 64% of them being from female patients compared to 36% from men. Approximately 73% of the isolates were resistant to trimethoprim-sulfamethoxazole and 91% resistant to amoxicillin clavulanic acid; 96% were susceptible to imipenem and 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). 37 Escherichia coli was the most prevalent clinical isolate (p value = 0.905) although there was 38 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. Conclusion: 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 district hospital.