Bacterial urinary tract infection among adult renal transplant recipients at St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia

Abstract Background Despite significant advances in surgical techniques, immunosuppression protocols, follow up periods and antimicrobial stewardship in modern medicine; post-renal transplantation urinary tract infection remained a major public health problem globally. This multiple serious squeals...

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Main Authors: Teklehaimanot Kiros, Daniel Asrat, Zeleke Ayenew, Estifanos Tsige
Format: Article
Language:English
Published: BMC 2019-07-01
Series:BMC Nephrology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12882-019-1485-9
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author Teklehaimanot Kiros
Daniel Asrat
Zeleke Ayenew
Estifanos Tsige
author_facet Teklehaimanot Kiros
Daniel Asrat
Zeleke Ayenew
Estifanos Tsige
author_sort Teklehaimanot Kiros
collection DOAJ
description Abstract Background Despite significant advances in surgical techniques, immunosuppression protocols, follow up periods and antimicrobial stewardship in modern medicine; post-renal transplantation urinary tract infection remained a major public health problem globally. This multiple serious squeals includes asymptomatic bacteriuria, cystitis and pyelonephritis. Among these, the bacterial origin of infection complications accounts for the most significant clinical, socio-economic impacts in many countries of the world. Therefore, the aim of the study was to investigate the prevalence of bacterial isolates that cause urinary tract infections, assess antibiotic susceptibility pattern among symptomatic and asymptomatic renal transplant recipients attending at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods A hospital-based cross-sectional study was conducted from December 2017 to August 2018 among 74 renal transplant recipients St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. A first morning voided clean-catch mid-stream urine specimens were collected and 0.001 ml inoculated onto blood and MacConkey agar plates following the standard bacteriological protocols. It was incubated aerobically at 35–37 °C for 24–48 h. Cultural characteristics and series of biochemical tests were used for the identification of isolates to species level based on the standard bacteriological protocols. Results A hospital-based cross-sectional study has shown that significant bacteriuria was found in 11/74 (14.9, 95% CI =8.2–24.7) patients. The prevalence among females 6/32 (18.75%) was higher among males 5/42 (11.9%) without significant association (COR = 2.09, 95% CI = 1.04–8.45, P = 0.253). Urinary tract infection was higher in the age group of 35–49 years old (19.3%). Age was statistically significant and stronger independent associated risk factor with crude odds ratio = 3.67, 95% CI = 2.89–20.07 and P = 0.003, respectively. The most prevalent bacteria isolates were Escherichia coli 2(18.2%), Staphylococcus aureus 2(18.2%), Acinetobacter spp. 2(18.2%), Enterococcus spp. 2(18.2%), Coagulase-negative Staphylococci 2(18.2%) followed by Porteus mirabilis 1(9.1%). The majority (80%) of Gram-negative bacteria were resistant to ciprofloxacin, chloramphenicol, and trimethoprim/sulfamethoxazole. Simultaneously, the multidrug-resistant bacterial isolates accounts for 82% among tested kidney allograft recipients. Conclusions In conclusion, the overall prevalence of urinary tract infection in the study participants was relatively low with a prevalence of 14.9%. Majority of the study participants were asymptomatic and a higher percentage of females were involved. The multidrug-resistant bacterial isolates in the present study account for 82%.
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spelling doaj.art-9c46e1aa4edb47bc9b863167404f3bd22022-12-22T00:59:36ZengBMCBMC Nephrology1471-23692019-07-012011710.1186/s12882-019-1485-9Bacterial urinary tract infection among adult renal transplant recipients at St. Paul’s hospital millennium medical college, Addis Ababa, EthiopiaTeklehaimanot Kiros0Daniel Asrat1Zeleke Ayenew2Estifanos Tsige3Department of Medical Microbiology, College of Medicine and Health Sciences, Debre Tabor UniversityDepartment of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa UniversityEthiopian Public Health InstituteEthiopian Public Health InstituteAbstract Background Despite significant advances in surgical techniques, immunosuppression protocols, follow up periods and antimicrobial stewardship in modern medicine; post-renal transplantation urinary tract infection remained a major public health problem globally. This multiple serious squeals includes asymptomatic bacteriuria, cystitis and pyelonephritis. Among these, the bacterial origin of infection complications accounts for the most significant clinical, socio-economic impacts in many countries of the world. Therefore, the aim of the study was to investigate the prevalence of bacterial isolates that cause urinary tract infections, assess antibiotic susceptibility pattern among symptomatic and asymptomatic renal transplant recipients attending at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods A hospital-based cross-sectional study was conducted from December 2017 to August 2018 among 74 renal transplant recipients St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. A first morning voided clean-catch mid-stream urine specimens were collected and 0.001 ml inoculated onto blood and MacConkey agar plates following the standard bacteriological protocols. It was incubated aerobically at 35–37 °C for 24–48 h. Cultural characteristics and series of biochemical tests were used for the identification of isolates to species level based on the standard bacteriological protocols. Results A hospital-based cross-sectional study has shown that significant bacteriuria was found in 11/74 (14.9, 95% CI =8.2–24.7) patients. The prevalence among females 6/32 (18.75%) was higher among males 5/42 (11.9%) without significant association (COR = 2.09, 95% CI = 1.04–8.45, P = 0.253). Urinary tract infection was higher in the age group of 35–49 years old (19.3%). Age was statistically significant and stronger independent associated risk factor with crude odds ratio = 3.67, 95% CI = 2.89–20.07 and P = 0.003, respectively. The most prevalent bacteria isolates were Escherichia coli 2(18.2%), Staphylococcus aureus 2(18.2%), Acinetobacter spp. 2(18.2%), Enterococcus spp. 2(18.2%), Coagulase-negative Staphylococci 2(18.2%) followed by Porteus mirabilis 1(9.1%). The majority (80%) of Gram-negative bacteria were resistant to ciprofloxacin, chloramphenicol, and trimethoprim/sulfamethoxazole. Simultaneously, the multidrug-resistant bacterial isolates accounts for 82% among tested kidney allograft recipients. Conclusions In conclusion, the overall prevalence of urinary tract infection in the study participants was relatively low with a prevalence of 14.9%. Majority of the study participants were asymptomatic and a higher percentage of females were involved. The multidrug-resistant bacterial isolates in the present study account for 82%.http://link.springer.com/article/10.1186/s12882-019-1485-9Kidney transplantationUrinary tract infectionUrine cultureAntimicrobial susceptibility testingAddis AbabaEthiopia
spellingShingle Teklehaimanot Kiros
Daniel Asrat
Zeleke Ayenew
Estifanos Tsige
Bacterial urinary tract infection among adult renal transplant recipients at St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia
BMC Nephrology
Kidney transplantation
Urinary tract infection
Urine culture
Antimicrobial susceptibility testing
Addis Ababa
Ethiopia
title Bacterial urinary tract infection among adult renal transplant recipients at St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia
title_full Bacterial urinary tract infection among adult renal transplant recipients at St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia
title_fullStr Bacterial urinary tract infection among adult renal transplant recipients at St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia
title_full_unstemmed Bacterial urinary tract infection among adult renal transplant recipients at St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia
title_short Bacterial urinary tract infection among adult renal transplant recipients at St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia
title_sort bacterial urinary tract infection among adult renal transplant recipients at st paul s hospital millennium medical college addis ababa ethiopia
topic Kidney transplantation
Urinary tract infection
Urine culture
Antimicrobial susceptibility testing
Addis Ababa
Ethiopia
url http://link.springer.com/article/10.1186/s12882-019-1485-9
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