Frequency and antibiotic resistance of bacteria isolated in urinary tract infections at Amirou Boubacar Diallo National Hospital, Niamey-Niger

Abstract

Title: Frequency and antibiotic resistance of bacteria isolated in urinary tract infections at Amirou Boubacar Diallo National Hospital, Niamey-Niger Introduction: Cytobacteriological examination of urine represents the most requested microbiological examination. It allows the diagnosis of urine tract infections (UTI). This study aimed to determine the bacteriological profile and antibiotic sensitivity pattern of patients with urinary tract infections at Amirou Boubacar Diallo National Hospital (HNABD). Methodology: This was a cross-sectional study that covered 6 months from January 1 to June 30, 2022. All patients who have benefited from urine cytobacteriological examination (UCBE) during the study were included Results: A total of 1739 patients were included in this study. Male patients were predominant with 1167 cases either a frequency of 67.11%. Most patients were men, aged from 45 to 60 years. The sex ratio was 2.16. The median age was 25 years with extreme of 4 days and 99 years. Clean–catch midstream urine collection was the most urine sampling. Of 1739 cytobacteriological examination of urine performed, 619 were positive with a frequency of 31.0% (n=619). Among positive cultures, 28% (n=488) were monomicrobial. Female patients were proportionally more affected by UTIs. However, there was no statistically significant difference between gender and UTI occurrence (p= 0.09). Patients aged from 45 to 60 years old were significantly more affected by UTI (p=0.0001). Among 488 monomicrobial cultures, Gram-negative bacillus (73%, n=356) were, so far, most represented; then followed by Gram-positive cocci (26%, n=127) and yeast (1%, n=5). Escherichia coli was the most isolated bacterium followed by Serratia odorifera and Klebsiella pneumoniae, with 35.29% (n=198); 8.38% (n=47), and 6.95% (n=39), respectively. Clinical isolates of Escherichia coli were sensitive to imipenem, cefoxitin, ceftriaxone, aminoglycosides, and nitrofurantoin. However, this bacterium was less sensitive to amoxicillin, amoxicillin-clavulanic acid, and ticarcillin. Conclusion: The prevalence of UTIs was relatively high at the HNABD. E. coli was the most frequently isolated bacterium in UTIs, regardless of the age, sex, or origin of the patients. While requests for cytobacteriological examination of urine were much more frequent in men, UTIs were proportionately more frequent in women and mainly concerned patients aged between 45 and 60. These data raise the question of the relevance of certain requests for cytobacteriological examination of urine in Niger. Keywords: Urinary Tract Infection, Escherichia coli, antibiotic resistance, Niger.