Multiple drug resistance bacterial isolates and associated factors among urinary stone patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Desie Kasew,Abeje Diress,Setegn Eshetie,Zerubabiel Tegegne,Feleke Moges

doi:10.1186/s12894-021-00794-8

Abstract

BackgroundThe urinary stone and urinary tract infection (UTI) are invariably associated and are frequent causes of morbidity. Date on burden of UTI among urinary stone patients is lacking in Ethiopia. This study was aimed to assess bacterial profile, antimicrobial susceptibility and associated factors among urinary stone patients at the University of Gondar Comprehensive Specialized Hospital.MethodsAn institution based cross sectional study was conducted. Basic sociodemographic data were collected using a structured questionnaire. Bacterial identification of uropathogens and drug susceptibility testing were done following standard microbiological techniques. The data were entered and analyzed using SPSS version-23. Bivariate and multivariate logistic regressions were used to identify possible associated risk factors. Results with P value < 0.05 was considered statistically significant.ResultA total of 300 urinary stone patients were enrolled. Of these, 153 (51%) were male and 261(87%) were urban residents. The overall prevalence of urinary tract infection was 49 (16.3%) (95% CI 12–21%). A high level of resistance was observed to ampicillin, penicillin and trimethoprim-sulfamethoxazole while majority of isolates were most sensitive to nitrofurantoin and ciprofloxacin. Multi-drug resistant isolates were 16/49 (32.7%), 75% of them being Enterobacteriaceae isolates. More than one-third 9/26 (34.6%) of Gram-negative isolates were Extended Spectrum Beta-Lactamase (ESBL) producing E. coli and K. pneumoniae. Being female, history of urinary tract infection and history of drug use were the independent risk factors.ConclusionMost of the bacterial isolates from urinary stone patients were resistant to ampicillin, penicillin and trimethoprim-sulfamethoxazole. E. coli and K. pneumoniae were the most common extended spectrum beta-lactamase producing isolates. Sex, history of urinary tract infection and previous drug use were found to be risk factors. Routine diagnosis of urinary stone patients for urinary tract infection should be promoted and further researches are encouraged.

Highlights

The urinary stone and urinary tract infection (UTI) are invariably associated and are frequent causes of morbidity
Most of the bacterial isolates from urinary stone patients were resistant to ampicillin, penicillin and trimethoprim-sulfamethoxazole
The prevalence of bacterial uropathogens among patients with urinary stone Forty-nine 49/300(16.3%) of the urinary stone patients had UTI

Summary

Introduction

The urinary stone and urinary tract infection (UTI) are invariably associated and are frequent causes of morbidity. Urinary stone and urinary tract infections (UTI) are constantly associated complaints of the urinary system [1]. Urinary stones known as urolithiasis [2] are hard masses produced in the urinary tract and cause infection, pain, bleeding or obstruction. Infection stones include magnesium ammonium phosphate or struvite (which accounts to 10–15% of urinary stone), carbonate apatite and ammonium urate. Urease producing bacteria such as Proteus are responsible for production of urease enzyme which alkalinizes urine and produce these stones [4, 5]. Ammonia and oxalate stones damage the urothelial layer facilitating microbial invasion [6]

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