History Of Catheterization Research Articles

Prevalence and Associated Factors of Urinary Tract Infections among Diabetic Patients: A Study at Kiryandongo Hospital, Uganda

Urinary tract infections (UTIs) pose a significant health concern, especially among individuals with diabetes mellitus. This study aimed to evaluate the prevalence and associated factors of UTIs among diabetic patients attending Kiryandongo Hospital in Uganda. A descriptive cross-sectional study design was employed, and data were collected using structured questionnaires. A total of 86 diabetic patients participated, with the majority being aged ≥50 years, married, and residing in rural areas. The prevalence of UTI among the studied patients was 14.0%. Age, sex, area of residence, duration of diabetes, history of UTI, and history of catheterization were identified as significant predictors of UTI. Females, older individuals, those with a longer duration of diabetes, and a history of UTI or catheterization were at higher risk of UTIs. These findings underscore the importance of screening and early treatment of UTIs in diabetic patients to mitigate associated complications andimprove health outcomes. Public health interventions aimed at UTI prevention and management should be prioritized among diabetic populations. Keywords: Urinary Tract Infections; Diabetes Mellitus; Prevalence; Associated Factors; Uganda Keywords: Urinary Tract Infections; Diabetes Mellitus; Patients, Glucose

Prevalence and Risk Factors of Urinary Tract Infection in Pregnant Women: Systematic Review and Meta-Analysis

Background: Urinary Tract Infections (UTIs) are the second-most frequent bacterial infections, with an overall incidence of 5-10%. This study aimed to investigate the prevalence and risk factors associated with UTI in pregnant women. Method: A systematic search was conducted in the open domain, electronic databases such as PubMed and Google Scholar. Citation searching was also performed to identify all relevant studies. All the steps were carried out by two independent reviewers to avoid bias. Based on inclusion & exclusion criteria, followed by qualitative evaluation, the studies were included and analyzed by fixed or random effects model using CMA. A sub-group analysis was also performed for Asian and African countries for prevalence and for different categories of risk factors. Results: Out of 45 studies, 41 studies were included for the prevalence of UTI in pregnant women and 19 studies were included to evaluate the risk factors. The pooled prevalence of UTI in African pregnant women was higher when compared to Asian pregnant women (28.6% vs. 20.7%). The risk factors statistically significantly associated with UTI were found to be undergarment texture (silk), history of catheterization, diabetes mellitus, past history of UTI and HIV. Conclusion: UTIs are prevalent in pregnant women in Asian and African pregnant women. Hence, identification of risk factors and frequent screening of UTIs during pregnancy is recommended to avoid maternal-fetal complications.

Risk factors for epidural anesthesia blockade failure in cesarean section: a retrospective study

BackgroundEpidural anesthesia (EA) is the regional anesthesia technique preferred over spinal anesthesia for pregnant women requiring cesarean section and post-operative pain control. EA failure requires additional sedation or conversion to general anesthesia (GA). This may be hazardous during sedation or GA conversion because of potentially difficult airways. Therefore, this retrospective study aimed to determine the risk factors for epidural failure during cesarean section anesthesia.MethodsWe retrospectively analyzed parturients who underwent cesarean section under EA and catheterization at the Chang Gung Memorial Hospital in Taiwan between January 1 and December 31, 2018. Patient data were collected from the medical records. EA failure was defined as the administration of any intravenous anesthetic at any time during a cesarean section, converting it into GA.ResultsA total of 534 parturients who underwent cesarean section were recruited for this study. Of them, 94 (17.6%) experienced EA failure during cesarean section. Compared to the patients with successful EA, those with EA failure were younger (33.0 years vs. 34.7 years), had received EA previously (60.6% vs. 37%), were parous (72.3% vs. 55%), and had a shorter waiting time (14.9 min vs. 16.5 min) (p < 0.05). Younger age (OR 0.91, 95% CI 0.86–0.95), history of epidural analgesia (OR 2.61, 95% CI 1.38–4.94), and shorter waiting time (OR 0.91, 95% CI 0.87–0.97) were estimated to be significantly associated with a higher risk of epidural anesthesia failure.ConclusionThe retrospective study found that parturients of younger age, previous epidural catheterization history, and inadequate waiting time may have a higher risk of EA failure. Previous epidural catheterization increased the risk of EA failure by 2.6-fold compared to patient with no history of catheterization.

Magnitude, Associated Risk Factors, and Trend Comparisons of Urinary Tract Infection among Pregnant Women and Diabetic Patients: A Systematic Review and Meta-Analysis.

Urinary tract infection (UTI) remains the most common bacterial infection that affects millions of people around the world, especially pregnant women (PW) and people with diabetes mellitus (DM). This systematic review and meta-analysis was aimed at finding the pooled prevalence of UTI and its associated risk factors among PW and DM patients. Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, Google Engine, and University Library Databases. "Prevalence," "urinary tract infection," "associated factors," "pregnant women," "diabetic patients," and "Ethiopia" were search terms used for this study. For critical appraisal, PRISMA-2009 was applied. Heterogeneity and publication bias were evaluated using Cochran's Q, inverse variance (I2), and funnel plot asymmetry tests. A random effect model was used to calculate the pooled prevalence of UTI and its associated factors among both patients, along with the parallel odds ratio (OR) and 95% confidence interval (CI). For this meta-analysis, a total of 7271 participants were included in the 25 eligible studies. The pooled prevalence of UTI in Ethiopia among both patients was 14.50% (95% CI: 13.02, 15.97), of which 14.21% (95% CI: 12.18, 16.25) and 14.75% (95% CI: 12.58, 16.92) were cases of DM and PW, respectively. According to the subgroup analysis, the highest prevalence was observed in the Oromia region (19.84%) and in studies conducted from 2018 to 2022 (14.68%). Being female (AOR: 0.88, and 95% CI: 0.11, 1.65, P = 0.01) and having an income level ≤ 500ETB (AOR: 4.46, and 95% CI: -1.19, 10.12, P = 0.03) were risk factors significantly associated with UTI among patients with DM and PW, respectively. Furthermore, a history of catheterization (AOR = 5.58 and 95% CI: 1.35, 9.81, P < 0.01), urinary tract infection (AOR: 3.52, and 95% CI: 1.96, 5.08, P < 0.01), and symptomatic patients (AOR: 2.32, and 95% CI: 0.57, 4.06, P < 0.01) were significantly associated with UTI in both patients. Early diagnosis and appropriate medication are necessary for the treatment of UTI in patients with DM and PW.

Clinical characteristics of hemodialysis patients with left brachiocephalic vein obstruction due to extrinsic compression or prior catheterization.

Left brachiocephalic vein (LBCV) stenosis is a common complication in hemodialysis patients and is a heterogenous disorder associated with either prior catheterization or extrinsic compression. This study aimed to characterize patients with LBCV stenosis or occlusion with and without a history of central venous catheterization. We performed a retrospective study in 84 hemodialysis patients with LBCV stenosis or occlusion with (n = 22) or without (n = 62) prior catheterization. We compared the clinical features, anatomical factors, restenosis after balloon venoplasty, and patency rates of patients in these two groups. In the cohort of 84 patients with LBCV stenosis or occlusion, 73.8% (62 patients) of them had no history of catheterization. Patients without prior catheterization had more stenotic lesions (p < 0.05) but less occlusive lesions (p < 0.05) than patients with prior catheterization. The space between the sternum and the aorta was narrower in patients without prior catheterization than that in patients with prior catheterization (p < 0.05). Percutaneous venography was performed in 81 patients, and the occurrence of recoil after venoplasty in patients without prior catheterization was significantly higher than that in patients with prior catheterization (p < 0.05). The rate of stent implantation was significantly higher in patients without prior catheterization than patients with prior catheterization (p < 0.05), whereas there was no significant difference in primary patency between the two groups. LBCV stenosis and occlusion are mainly due to extrinsic compression rather than prior central venous catheterization. Stent implantation is frequently required after venoplasty to treat LBCV obstructive lesions in patients without prior catheterization.

Arabic gum as a natural therapeutic agent for diabetic patients with CKD: A retrospective study

Arabic gum (AG) is a dietary additive widely used in food manufacture and drugs; it has also gained popularity as herbal tea that can cure diseases such as diabetes, hypertension, and chronic kidney disease. Studies showed its antioxidant and anti-inflammatory effects. In a retrospective study design, we included CKD patients taking AG for at least three months. Data were collected over one year for each patient: age, co-morbidities, duration, amount of AG used, serum creatinine, inflammatory markers, lipid profile, blood sugar, hemoglobin A1C, and blood pressure readings. For the changes in values and trends, we compared the values individually for each patient separately. A&lt;b&gt; &lt;/b&gt;total of 30 patients consisted of 20 males (66.7%) and 10 females (33.3%), with a mean age of 63.2 years. The mean (M) eGFR pre-enrollment in the study was 23.5 ml/min (standard deviation [SD]=15.8), and the mean eGFR at the end of the study was 26.1 ml/min (SD=18.9, p=0.56). There was a significant difference in the eGFR after using AG between diabetics (M=31.3 ml/min, SD=18.5) and non-diabetics (M=20.5 ml/min, SD=18.2, p=0.03). With a history of catheterization, there was a significant difference in eGFR between patients who had catheterization (M=31.76, SD=20.86) and patients without catheterization (M=18.36, SD=13.08, p=0.04). No significant effect on lipid profile, or CRP, yet significant effect on blood sugar control (fasting blood sugar 0.0001, and HBAa1c 0.01). In conclusion, AG is a promising natural material that affects decreasing eGFR in CKD diabetics patients.

MOST COMMON PATHOGENIC ORGANISMS CAUSING URINARY TRACT INFECTION IN DIABETIC VERSUS NONDIABETIC PATIENTS AND THEIR ANTIBIOTIC SENSITIVITY PATTERNS

Background: To identify the most common pathogen causing urinary tract infection in diabetics versus nondiabetics and their antibiotic susceptibility. Material and Method: This case control study was conducted Combined Military Hospital Mardan, August 2022 - January 2023. Using a stratified sampling technique 90 patients were divided into Group DM and Group NDM with 45 participants in each group. History, demographic characteristics, symptomatology and empirical treatment prescribed was recorded for each patient and midstream urine sample was collected. Urine culture and sensitivity was performed to identify the organisms and antibiotic susceptibility of the causative agent. Recorded variables included the organisms identified and their sensitivity patterns. Results: Gender distribution revealed males were 17(37.8%) versus 12(26.7%) from Group DM and Group NDM with a mean age of the participants was 54.64 ± 9.74 years. Clinical features like history of UTI, history of catheterization, asymptomatic bacteriuria was seen more in diabetics as compared to non-diabetics with a p value of &lt; 0.05. Escherichia Coli was the most common causative organism found in 44 (48.5%) out of 90 patients in both diabetic and non-diabetic patients. Antibiotic susceptibility revealed increased sensitivity of Escherichia Coli to Fosfomycin (88.6%) followed by nitrofurantoin (81.8%) and meropenem (75%). Conclusion: Escherichia coli is the most common isolate causing urinary tract infection in diabetic and non-diabetic patients which shows greatest sensitivity to Fosfomycin, nitrofurantoin and meropenem. Key Words: Antibiotic susceptibility, Culture, Pathogen, Sensitivity.

Age-specific differences in hypertension combination management and associated factors influencing treatment choice.

The current hypertension guideline emphasizes combination therapy, especially single-pill combination therapy (SPC). However, few studies compared the prevalence and factors associated with initial therapy choice across heterogeneous age groups in a current population. First, the authors consecutively identified 964 treatment naïve hypertensive patients in a large academic hospital from 01/31/2019 to 01/31/2020. All patients were grouped into (1) young aged, age<55; (2) middle-aged, 55≤age<65; and (3) older aged, age ≥65. The multivariable regression model examined the factors associated with the combination therapy by age group. Overall, 80 (8.3%) were young, 191 (19.8%) were middle, and 693 (71.9%) were older aged. Compared with older age, younger patients were more likely to be male, highly educated, regularly exercised, have metabolic syndrome, and less likely to have cardiovascular-related comorbidities, with a lower systolic but higher diastolic pressure. Only one in five patients used SPC, and the prevalence decreased with age. Besides hypertension grade, young patients without catheterization or echo test were less likely to receive multiple therapies, while older patients who were male with lower weight and lower risk levels were less likely to receive multiple therapies. In conclusion, combination therapy, especially SPC, was underused in the targeted hypertensive population. Our contemporary population study showed that young patients (<55) without a history of catheterization or echo examination and male older-aged (≥65) patients with low-risk classification were the population most likely to be neglected. Such information can help triage medical care resources in improving SPC use.

Uropathogenic bacterial profile and antibiotic susceptibility pattern of isolates among gynecological cases admitted to Jimma Medical Center, South West Ethiopia

Urinary tract infection (UTI) is one of the most common bacterial infections in women; about 50% of women get during their life time. Moreover, it is a common health problem in patients with gynecological pathologies, which increases the chance of acquiring infection. The aim of this study was to determine the bacterial profile that causes UTI and their antibiotic susceptibility pattern among admitted gynecological cases. A cross-sectional study was conducted in south west Ethiopia region. A total of 386 patients admitted with gynecological cases were recruited by sequential sampling technique and structured questionnaire was used to collect socio-demographic and risk factor-related data. About 10 ml freshly voided midstream and catheterized urine specimens were collected using sterile containers. Identification of isolate was done using culture characteristics, gram staining, and a series of biochemical tests. The antibiotic susceptibility test was performed as per the Kirby–Bauer disc diffusion technique. The data obtained were entered into EpiData Version 3.1 and analyzed using SPSS Version 25. A P value of less than 0.05 was used as a level of significance. In this study, the overall prevalence of UTI was 25.4%. Escherichia coli was the most frequently isolated bacteria, which accounted for 38 (37.6%), followed by Klebsiella species 22 (21.8%), CONS 14 (13.9%), Staphylococcus aureus 10 (9.9%), Enterobacter species 6 (5.9%), Citrobacter species 5 (4.9%), Proteus mirabilis 4 (4%), and Pseudomonas aeroginosa 2(2%). Histories of UTI (AOR = 1.977, 95% CI 1.06, 3.68, P = 0.032) and catheterization (AOR = 2.38, 95% CI 1.28, 4.45, P = 0.006) were found to be statistically associated with significant bacteriuria. Gram-negative isolates showed a high level of resistance, 88.3% for ampicillin and 66.2% for tetracycline, and a relatively low level of resistance against ceftazidime, 22.1%, and meropenem, 3.9%. Gram-positive uropathogens showed a high level of resistance to penicillin, 91.6%, whereas all isolates were sensitive 100.0% to nitrofurantoin. Furthermore, 80 (79.2%) of the isolates had multidrug resistance, and 16 (26.7%) of both E. coli and Klebsiella spp. produced Extended spectrum β-lactamase (ESBL). In this study, a high prevalence of uropathogenic bacteria and multidrug resistance for commonly prescribed drugs were observed with a significant number of ESBL producers. Therefore, screening admitted gynecological patients, especially for those who have history of catheterization and UTI, by urine culture and antimicrobial susceptibility testing is important.

A100 CAVERNOUS TRANSFORMATION OF THE PORTAL VEIN IN A PEDIATRIC PATIENT WITH GOLDENHAR SYNDROME: A CASE REPORT

Abstract Background Goldenhar syndrome is a rare congenital condition thought to arise from the first and second branchial arches and typically asymmetrically affects the eyes, ears, and spine. Portal vein thrombosis/cavernous transformation is one of the main causes of portal hypertension in children. It is often associated with risk factors such as catheterization of the umbilical vein in the neonatal period, omphalitis, intra-abdominal infections in the neonatal period and prothrombotic conditions. This is a challenging clinical scenario as it leads to portal hypertension and variceal bleed with no chronic liver disease stigmata and liver function is essentially normal. While previous European literature from the early-2000s reported associated portal vein anomalies in Goldenhar syndrome, we are not aware of any recent and/or Canadian pediatric cases. Purpose We report a Canadian case of cavernous transformation of the portal vein with resulting gastrointestinal bleeding in a child with Goldenhar syndrome. Method Case report Result(s) A pediatric patient with a postnatal suspicion of Goldenhar syndrome, with confirmation by 6 months of age, presented with an acute 3-day history of melena, on the context of a recent viral illness and ibuprofen use. Laboratory testing showed a normocytic anemia (Hb 68) with a normal INR (1.1). The rest of the workup was unremarkable. There was no history of catheterization of the umbilical vein on the neonatal period nor other hematological complications. To assess for potential duplication cyst as differential diagnosis, a computerized tomography of the chest, abdomen and pelvis was ordered and revealed suspected cavernous transformation of the portal vein with suspected varices near the gastroesophageal junction and within the abdomen, and hepatomegaly with spleen size at the upper limit of normal. Octreotide was started after the CT results. A gastroscopy was done 24h after presentation and found portal hypertensive gastropathy and esophageal varices (2 Grade II and 1 Grade I). Sclerotherapy was performed. Post-gastroscopy ultrasound supported earlier radiographic findings of cavernous portal vein transformation and hepatosplenomegaly. Moreover, the ultrasound noted normal flow direction in the portal and hepatic veins. The patient has not re-presented for further episodes of gastrointestinal bleeding. Conclusion(s) This case report supports the previously reported association between Goldenhar syndrome and portal venous anomalies. Early consideration may lead to prompt diagnosis and management of the potentially life-threatening complications of portal hypertension in this population. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared

Asymptomatic Carriage Rate, Multidrug Resistance Level, and Associated Risk Factors of Enterococcus in Clinical Samples among HIV-Positive Patients Attending at Debre Birhan Comprehensive Specialized Hospital, North Showa, Ethiopia.

Enterococci are facultative anaerobic, Gram-positive bacteria found in pairs and short chains that exist as normal microflora both human and animal. Enterococci have become a substantial source of nosocomial infections in immunocompromised patients, such as urinary tract infection (UTI), bacteremia, endocarditis, and wound infection. Earlier antibiotic therapy, length of hospital stays, and length of earlier vancomycin treatment, surgical wards, or intensive care units are all risk factors. Additionally, the presence of coinfections such as diabetes and renal failure and the presence of a urinary catheter were aggravated factors to develop infections. Data on the prevalence, antimicrobial susceptibility patterns, and associated factors of enterococcal infection among HIV-positive patients are scarce in Ethiopia. To determine the asymptomatic carriage rate, multidrug resistance pattern, and risk factors of enterococci in clinical samples among HIV-positive patients attending at Debre Birhan Comprehensive Specialized Hospital, North Showa, Ethiopia. A hospital-based cross-sectional study was conducted from May to August 2021, at Debre Birhan Comprehensive Specialized Hospital. To obtain sociodemographic data and possible associated factors of enterococcal infections, a pretested structured questionnaire was utilized. During the study period, clinical samples such as urine, blood, swabs, and other bodily fluids from participants sent to the bacteriology section for cultures were included. The study comprised a total of 384 HIV-positive patients. Enterococci were identified and confirmed using bile esculin azide agar (BEAA), Gram stain, catalase response, growth in broth containing 6.5% NaCl, and growth in BHI broth at 45°C. Data were entered and analyzed using SPSS version 25. P values < 0.05 with 95% confidence interval were considered statistically significant. The overall asymptomatic carriage rate of enterococcal infection was 8.85% (34/384). Urinary tract infections were the most common, followed by wounds and blood. The vast majority of the isolate was found in urine, blood, and wound and fecal, 11 (32.4%), 6 (17.6%), and 5 (14.7%), respectively. Overall, 28 (82.35%) bacterial isolates were resistant to three and more than three antimicrobial agents. Duration of hospital associated with >48-hour hospital stays (AOR = 5.23, 95% C.I: 3.42-24.6), previous history of catheterization (AOR = 3.5, 95% C.I: 5.12-44.31), WHO clinical, stage IV (AOR = 1.65, 95% C.I: 1.23-3.61), andCD4 count < 350(AOR = 3.5, 95% C.I: 5.12-44.31) (P < 0.05). All were associated with higher level of enterococcal infection than their respective groups. Conclusion and Recommendation. Patients with UTIs, sepsis, and wound infection had a greater rate of enterococcal infection than the rest of the patients. Clinical samples in the research area yielded multidrug-resistant enterococci, including VRE. The presence of VRE suggests that multidrug-resistant Gram-positive bacteria have fewer antibiotic treatment options.

Prevalence of Urinary Tract Infection among Children - a cross-sectional study in Arar city, Northern Border Area, KSA

Background: Urinary tract infection (UTI) is one of the most common infections in children. The prevalence of UTI during childhood varies by gender, age, and multiple other factors. The most commonly causes of UTI in children are E. coli and Klebsiella in different parts of the world. Aim: To evaluate the prevalence of UTI, its etiologic pathogens, presenting symptoms and probable risk factors in our area. Methods; A retrospective cross-sectional study was conducted on electronic files of 606 pediatric participants of confirmed UTIs from year 2015 -2020 in arar city hospital. These cases were diagnosed after urine culture positive for the respected uropathogens. Urine samples were collected either transurethral in &lt; 1year children and clean voided midstream in elder children under aseptic techniques. The samples were sent to the hospital lab with especial request that we would use these samples for our study. Hospital laboratory followed full protocol that is followed worldwide. Results: Total of 606 confirmed cases of UTI were used. Of this, 370(61.05%) were females and 236 (38.94%) males. Among them, 253 (41.74%) were &lt;1 year old, 229(37.78%) were 1–5-year-old whereas 124(20.46%) were above 5 years old children. We found that E. coli was the most prevalent organism 342(56.23%), followed by Klebsiella which was 175(28.8%). E. coli was more common in outpatients compared to Klebsiella which was the most common aetiologic agent isolated from hospital admitted patients. Citrobacter, Enterococci, Actinobacteria and Pseudomonas aeruginosa were commoner in hospital patients. High grade fever, dysuria and foul smelling was the main symptom of E. coli positive cases whereas foul smelling was common in Klebsiella positive cultures. Constipation was noted to be the most common 198(32.6%) risk factor in our area. Other risk factors were history of instrumentation, history of catheterization, structural abnormalities, and posterior urethral valve abnormalities which were 9.9 %, 9.9 %, 10.2% and 3.30% respectively. Conclusion: We conclude first; Prevalence of UTI was more common in females than males in &lt; 1 year old group. Second; E.coli was the most common bacteria followed by Klebsiella. Third; it showed that along with other risk factors, constipation plays a significant role in causation of UTI in our area. Keywords; UTI, children, risk factors

Status and influencing factors of patients with kinesiophobia after insertion of peripherally inserted central catheter: A cross-sectional study.

This study aimed to investigate the current status and influencing factors of kinesiophobia in patients after insertion of peripherally inserted central catheter (PICC).A total of 240 patients with PICC were included. Their postinsertion status and influencing factors were investigated using the general information questionnaire, Tampa Scale of Kinesiophobia (TSK), Medical Coping Modes Questionnaire, Numerical Rating Scale, and Self-rating Anxiety Scale.The mean TSK score was 36.49 ± 4.19 points, and 89 patients (37.08%) had kinesiophobia. Multiple linear regression analysis showed that factors such as education level, age, monthly income level, catheterization history, face, pain level, anxiety, and number of needle insertions influenced postoperative kinesiophobia in patients with PICC (P < .05). The total variation in the TSK score was 71.8%.The incidence of kinesiophobia was relatively high after PICC insertion. The medical staff needs to undertake targeted intervention measures to help minimize kinesiophobia after PICC insertion, allowing patients to perform scientifically correct functional exercises and attain physical recovery.

Urinary Tract Infection and Its Risk Factors in a Tertiary Care Hospital

Background: Urinary tract infection (UTI) is common health issue all over the world and several factors predispose the people to urinary tract infection.&#x0D; Objective: The study aimed at determining the incidence of Urinary tract infection and factors associated with it.&#x0D; Material and Methods: This cross-sectional study was performed among 205 patients in a tertiary care hospital of Rawalpindi, Pakistan. Simple convenient sampling and an established inclusion and exclusion criteria was applied to select the participants. After obtaining the informed consent from all participants, data was acquired via a self-designed proforma. Data analysis was carried out through SPSS version 25. Chi square test was applied to check the association between urinary tract infection and predisposing factors. The p-value less than 0.05 was taken as statistically significant.&#x0D; Results: The incidence of urinary tract infection was 12.68%. Urinary tract infection was significantly associated age group (p=0.003), gender (p=0.001), marital status (p=0.004), educational status (p=0.0001), socioeconomic status (p=0.005), previous history of UTI (p=0.0002), family history of UTI (p=0.0004), history of stone in urinary tract (p=0.003), history of recent use of antibiotics (p=0.04), history of catheterization (p=0.001), hygienic condition of external genitalia (p=0.0005), frequency of intercourse (p=0.04), history of diabetes mellitus (p=0.002), and hydration status (p=0.0007), whereas, association of urinary tract infection with holding urine was insignificant (p=0.05).&#x0D; Conclusion: The incidence of urinary tract infection was high among research population. Risk factors that could lead to UTI were young age, female gender, married marital status, lower educational status, lower socioeconomic status, previous history of UTI, family history of UTI, history of stone in urinary tract, history of recent use of antibiotics, history of catheterization, poor hygienic condition of external genitalia, high frequency of intercourse, history of diabetes mellitus, and dehydration.&#x0D; Recommendations: People should be educated about the UTI and its causes and prevention. People should also take special care when they are on antibiotics or when they are diabetics, to prevent UTI. People should maintain hygiene when they are catheterized and during intercourse. People should stay hydrated.

Magnitude and associated factors of urinary tract infections among adults living with HIV in Ethiopia. Systematic review and meta-analysis.

BackgroundUrinary tract infection is a major public health problem in developing countries among immunocompromized populations where there are limited health-care services. People living with human immunodeficiency virus (HIV) are more likely to develop urinary tract infections (UTI) due to the suppression of their immunity. There is no single representative figure as well as the presence of significant heterogeneity among studies conducted on people living with HIV in Ethiopia. Hence, this study tried to pool the magnitude of UTI among people living with HIV in Ethiopia.MethodTo find relevant studies, researchers looked through Web of Science, Science Direct, PubMed, EMBASE, the Cochrane Library, Google Scholar, and Worldwide Science. The I2 statistic was used to examine for heterogeneity among the studies that were included. To evaluate the pooled effect size across studies, a random-effects model was used. The presence of publication bias was determined using a funnel plot and Egger’s regression test. STATATM version 14.0 software was used for all statistical analyses.ResultsA total of 7 studies with 2257 participants were included in this meta-analysis. UTI was shown to be prevalent in 12.8% (95% CI: 10.8–14.79, I2 = 50.7%) of HIV patients. Being male (0.35, 95% CI:0.14, 1.02), rural residents(OR:1.41,95% CI: 0.85, 2.34), no history of catheterization (OR: 0.35, 95% CI: 0.06, 1.85), had no history of DM (OR:0.84, 95% CI:0.12, 0.597) and having CD4 count greater than 200 (OR:0.36 95% CI: 0.06, 2.35) were the factors which were the associated factors assessed and having association with UTI among people living with HIV but not statistically significant.ConclusionsIn Ethiopia, one in every eight HIV-positive people is at risk of acquiring UTI. Regardless, we looked for a link between sex, residency, CD4, catheterization history, and DM and UTI, but there was none. To avoid this phenomina, every HIV patient should have a UTI examination in every follow-up.

Prevalence and Risk Factors Associated with Extended-spectrum β-lactamase-Producing Bac­teria among Pregnant Women Attending Three Secondary Health Care Facilities in Nigeria

Background: Extended- spectrum beta-lactamases (ESBL) are enzymes produced by members of the En­terobacteriaceae which can hydrolyse the beta-lactam antibiotics like penicillins and cephalosporins and thereby confer antibiotic resistance on strains producing them. Bacterial isolates producing ESBLs have spread around the world. The ESBLs are encoded by several genetic elements on the chromosome and plas­mids. This study was carried out to determine the prevalence of ESBL producing Gram-negative bacteria and their risk factors in pregnant women attending antenatal care at three General Hospitals in Akwa Ibom State, Nigeria. Methods: 660 urine specimens were collected from the women between July and December 2018. The specimens were inoculated on MacConkey agar and incubated at 370C for 24h. The biochemical characteri­sation of the isolates was done using the Microbact 24E (Oxoid Ltd, UK). Antibiotic susceptibility testing was done by the Kirby-Bauer disc agar diffusion method. The isolates were tested for the production of ESBL using a Double Disc. Synergy test and CHROMagar ESBL Results: A total of 252 isolates comprising 231(92%) ESBL producers were recorded. In this study, Entero­bacter cloacae was the most frequently isolated ESBL producer (25.7%), followed by Escherichia coli (20.2%) and Klebsiella pneumoniae (16.3 %). The most relevant risk factors for ESBL producing bacteria were previous use of antibiotics (p&lt; 0.05), personal hygiene (p&lt; 0.05) and history of catheterisation (p&lt; 0.05). Conclusion: This calls for urgent public health measures to implement antimicrobial resistance stewardship to mitigate against the potential adverse effects of the spread of resistant bacteria which are vital in manag­ing severe bacterial infections

Prevalence and antimicrobial susceptibility pattern of urinary tract infection among pregnant women attending Hargeisa Group Hospital, Hargeisa, Somaliland

The aim of this study was to determine the prevalence, antimicrobial susceptibility pattern and associated factors of urinary tract infection (UTI) among pregnant women attending Hargeisa Group Hospital (HGH), Hargeisa, Somaliland. A cross-sectional study was conducted at HGH, Hargeisa, Somaliland and participants were selected by systematic random sampling technique. Clean catch midstream urine samples were collected from 422 participants and cultured and antimicrobial susceptibility pattern was determined for the isolates. Univariable and multivariable logistic regression analyses were utilized to identify the independent risk factors for UTI. The prevalence of UTI was 16.4% (95% CI 13.3–19.9). The predominant bacteria isolate was E. coli (43.5%) followed by Coagulase negative staphylococcus (CoNS) 11(16%), S. aureus 9(13%), K. pneumonia 6(8.7%), Pseudomonas aeruginosa 5(7.2%), Proteus mirabilis 4(5.8%), Citrobacter spp 3(4.4%) and M. morganii 1(1.5%) Gram negative bacilli were resistant to ampicillin (96%) and tetracycline (71.4%) and Gram-positive cocci were also resistant to ampicillin (90%), tetracycline (55%). Multidrug resistance was observed in 85.5% of bacterial isolated. No formal education participants, previous history of catheterization and previous history of UTI had 3.18, 3.22 and 3.73 times respectively more likely to develop UTI than their counterparts. Culture and susceptibility test is vital for appropriate management of UTI in the study area.

Urinary tract infection, antimicrobial susceptibility pattern of isolates, and associated factors among women with a post-fistula at public health facilities, Harar, eastern Ethiopia: A cross-sectional study.

Introduction:Urinary tract infection remains one of the major public health problems among post-fistula patients worldwide, particularly in sub-Saharan Africa. Besides, antimicrobial resistance impedes the effective infection prevention and treatment of ever-increasing bacteria. There was a paucity of data on urinary tract infections and the antimicrobial susceptibility profile of bacteria among post-fistula patients.Objective:To determine the prevalence, antimicrobial susceptibility pattern, and associated factors of urinary tract infections among women with post-fistula attending public health facilities, Harar, eastern Ethiopia.Methods:An institutional-based cross-sectional study was conducted among 146 consecutively enrolled women with post-fistula from February 2017 to December 2018. Risk factors were collected using a structured questionnaire. The midstream urine was collected, cultured and bacteria species were identified by using standard culture methods. Antimicrobial susceptibility testing was done by the disk diffusion technique. The association between independent and outcome variables was computed by using logistic regression analysis. A p-value < 0.05 was considered statistically significant.Results:The prevalence of urinary tract infections was 28.8% (95% confidence interval: 23.4, 33.6). Escherichia coli (19.1%), Pseudomonas aeruginosa (14.3%), and Proteus species (11.9%) were the commonest isolates. E. coli showed (75%) resistance to trimethoprim–sulfamethoxazole, amoxicillin (62.5%), and ciprofloxacin (62.5%). Staphylococcus aureus was shown 80% resistance to amoxicillin and erythromycin. Giving birth to a single baby (adjusted odds ratio: 0.3, 95% confidence interval: 0.1, 0.8), illness by a fistula for less than 3 years (adjusted odds ratio: 0.2, 95% confidence interval: 0.1, 0.6), and lack of a previous history of catheterization (adjusted odds ratio: 0.3, 95% confidence interval: 0.1, 0.9) decrease the odds of having urinary tract infections.Conclusion:Gram-negative organisms were the commonest cause of urinary tract infections in women with post-fistula. E. coli and P. aeruginosa showed higher resistance to most antimicrobials in the panels. Fistula patients need to be screened for urinary tract infections before antimicrobial treatment is indicated.

Drug Susceptibility Pattern and Associated Factors of Bacteria Isolated from Urinary Tract Infection among Pregnant Women Attending Antenatal Care in Teaching Referral Hospital, Southeast Ethiopia

Background: Urinary tract infection (UTI) is caused by bacteria from the digestive tract which climbs the opening of the urethra and begins to multiply to cause infection. UTI in pregnancy is associated with significant morbidity for both mother and baby. In most developing countries including Ethiopia, screening for UTI in pregnancy is not considered an essential part of Antenatal Care. This study aimed to assess the bacterial profile and antibiotic susceptibility pattern and associated risk factors among pregnant women in Madda Walabu University Goba Referral Hospital, Southeast Ethiopia. Methods: An institution-based cross-sectional study was conducted from June-August, 2020 . A total of 234 pregnant women were enrolled; data were collected using a structured questionnaire by a trained interviewer. Urine samples were collected from all pregnant women and culture on cysteine lysine electrolytes deficiency medium. Data were analyzed using SPSS 20.0. Descriptive statistics were used to explain the study participants with relevant variables. Logistic regression was used for data comparison. P-value &lt;0.05 was accepted as statistically significant. Results: The overall prevalence of UTI was 23.9% among both asymptomatic and symptomatic groups. Of this screened midstream urine samples showed that 16% and 32.2%, had significant bacteriuria in the asymptomatic and symptomatic groups respectively. The prevalence of UTI was significantly associated with previous history of catheterization and urinary tract infection (p&lt;0.05). E. coli was the most frequently isolated organism (42.9%) followed by coagulase-negative Staphylococcus (26.8%), and S. aureus (12.5%). Gram-negative and Gram-positive bacteria accounted for (59%) and (41%) respectively. Gram-negative isolates showed resistance to ampicillin, naldixic acid and trimethoprim/sulfamethoxazole. Also, all Gram-negative bacterial isolates revealed a high level of resistance against trimethoprim/sulfamethoxazole. Conclusion: Significant bacteriuria has been observed from both symptomatic and asymptomatic pregnant women. The majority of the isolates were resistant to commonly prescribed antibiotics. This calls for an early screening of all pregnant women for UTI and those found to be infected need treatment with an appropriate drug to avoid complications.

Prevalence of Urinary Tract Infection and Its Associated Factors among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis.

Objective Urinary tract infection (UTI) is the most common bacterial infections during pregnancy. It is associated with different maternal and neonatal adverse outcomes such as low birth weight, preterm birth, still birth, preeclampsia, maternal anemia, sepsis, and amnionitis, even when the infection is asymptomatic. However, in Ethiopia, it is represented with fragmented and inconclusive pocket studies. Therefore, this systematic review and meta-analysis is aimed at estimating the pooled prevalence of UTI and its associated factors among pregnant women in Ethiopia. Methods PubMed/Medline, Embase, Cochrane Library, Google Scholar, and local sources were used to access eligible studies. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was applied for critical appraisal. Heterogeneity and publication bias were evaluated using I2 statistic, funnel plot asymmetry, and Egger's tests. Random effect model was employed to estimate the pooled burden of UTI and its associated factors among pregnant women with its corresponding odds ratio (OR) and 95% confidence interval (CI). Result From all systematically searched articles, 14 studies were eligible for this analysis. The overall pooled prevalence of UTI among pregnant women in Ethiopia was 15.37% (95% CI: 12.54, 18.19). Family monthly income (OR = 3.8 and 95% CI: 1.29, 11.23), parity (OR = 1.59 and 95% CI: 1.01, 2.50), history of catheterization (OR = 2.76 and 95% CI: 1.31, 5.84), and history of UTI (OR = 3.12 and 95% CI: 1.74, 5.60) were factors significantly associated with UTI among pregnant women in Ethiopia. Conclusion The overall pooled estimate of UTI among pregnant women in Ethiopia was higher compared with CDC estimation which was 8%. Family monthly income < 1000ETB, multipara, previous history of catheterization, and history of UTI were factors increased burden of UTI during pregnancy. So, strategies targeting in economic reforms, universal access of family planning, and standardized prenatal care service should be addressed to alleviate this high prevalence of UTI during pregnancy.