Antibiotic Resistance Trends Among Out-patients With Urinary Tract Infections In North Western Tanzania
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BACKGROUND
Urinary tract infections (UTIs) are among the most common infections in the community and hospital settings and Enterobacteriaceae , are responsible for most infections. This study determined the prevalence and resistance trends of E. coli and K. pneumoniae to fluroquinolones and cephalosporins among out-patients diagnosed with urinary infections at a Zonal tertiary hospital in Tanzania
METHODS
This was a prospective cross sectional time series conducted in northern Tanzania and enrolled all out patients presenting with UTI symptoms. The study conducted for a period of six months between march 2021 to September 2021.
RESULTS
During the study period1582 patients were enrolled, the mean age was 20.2(SD 22.2) years and 883(55.8%) were female. The prevalence of E. coli was higher in female patients at 12.0% compared 6.7% in male. Both E. coli and K. pneumoniae were most prevalent in patients over >45 years at 13.3% and 3.2% respectively. E . coli resistance to Ceftriaxone, cefepime, and ciprofloxacin was 41.0%, 36.8% and 51.0% respectively. Resistance K. pneumoniae to ceftriaxone, cefepime, and ciprofloxacin was shown to be 52.8%, 47.4% and 28.2% respectively. Meanwhile, 76/192(39.6%) isolates were identified as ESBL.
CONCLUSIONS
In this setting empirical treatment of urinary tract infections with ciprofloxacin a commonly prescribed antibiotics for this diagnosis may not work in over half of patients when E,coli is the causative pathogen. Moreover, E. coli , resistance of 43% to ceftriaxone implies that patients who do not respond to initial therapy with ciprofloxacin, are at a risk of not responding to subsequent therapy necessitating the use of reserve antibiotics.
