Background
Methods
Specimen collection
Isolation and identification of Uropathogens
Antimicrobial susceptibility testing
Quality control
Statistical analysis
Results
Socio-demographic characteristics of the study participants
Socio-demographic Characteristics | Classifications of variables | Frequency No. (%) |
---|---|---|
Age | 20–35 | 51(20.6) |
36–45 | 45(18.1) | |
46–55 | 52(21) | |
≥56 | 100(40.3) | |
Sex | Male | 112(45.2) |
Female | 136(54.8) | |
Address: | Urban | 210(84.7) |
Rural | 38(15.3) | |
Marital Status: | Single | 31(12.5) |
Married | 153(61.7) | |
Widowed/Divorced | 64(25.8) | |
Literacy level: | Illiterate | 84(33.9) |
Primary School | 63(25.4) | |
Secondary School | 58(23.4) | |
Higher education | 43(17.3) | |
Types of diabetes: | Type I | 123(49.6) |
Type II | 125(50.4) | |
Duration of diabetes(in years): | < 5 | 65(26.2) |
5–10 | 93(37.5) | |
≥10 | 90(36.3) | |
Blood glucose level(mg/dl): | < 126 | 99(39.9) |
≥126 | 149(60.1) | |
History of previous UTI: | Yes | 73(29.4) |
No | 175(70.6) | |
History of previous antibiotic: | Yes | 106(42.7) |
No | 142(57.3) |
Prevalence and isolated Uropathogens
Uropathogens Isolated | Species | UTI status | ||||
---|---|---|---|---|---|---|
Asymptomatic | Symptomatic | |||||
Male | Female | Male | Female | Total | ||
No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | ||
Bacterial |
E. coli
| 1(7.7) | 3(23.1) | 2(15.4) | 7(53.8) | 13(35.1) |
CNS | 2(28.6) | 1(14.2) | 2(28.6) | 2(28.6) | 7(18.9) | |
Enterococcus spp. | 1(16.7) | 1(16.7) | 2(33.3) | 2(33.3) | 6(16.2) | |
S. aureus
| 1(25) | 1(25) | 2(50) | 0(0) | 4(10.8) | |
K. pneumoniae
| 0(0) | 0(0) | 1(50) | 1(50) | 2(5.4) | |
P. mirabilis
| 1(50) | 0(0) | 1(50) | 0(0) | 2(5.4) | |
Enterobacter Spp. | 0(0) | 0(0) | 2(100) | 0(0) | 2(5.4) | |
CitrobacterSpp. | 1(100) | 0(0) | 0(0) | 0(0) | 1(2.7) | |
Total | 7(18.9) | 6(16.2) | 12(32.4) | 12(32.4) | 37(100) | |
Candida |
C. albicans
| 0(0) | 2(20) | 2(20) | 6(60) | 10(52.6) |
Non-albicans Candida Spp. | 1(11.1) | 5(55.6) | 0(0) | 3(33.3) | 9(47.4) | |
Total | 1(5.3) | 7(36.8) | 2(1.5) | 9(47.4) | 19(100) |
Risk factors associated with urinary tract infection
Characteristics | Significant uropathogens No. (%) | Crude- OR (95.0%CI) | Adjusted-OR (95.0% CI) | ||
---|---|---|---|---|---|
OR(Lower-Upper) | P-value | OR(Lower-Upper) | P-value | ||
Age: | |||||
20–35 | 18(32.1) | 1 | 1 | ||
36–45 | 10(17.8) | 0.52(0.21–1.29) | 0.16 | 0 .55(0.19–1.54) | 0.25 |
46–55 | 10(17.8) | 0.44(0.18–1.07) | 0.07 | 0.29(0.1–0.87) | 0.03 |
≥ 56 | 18(32.1) | 0.4(0.19–0.87) | 0.02 | 0.19(0.08–0.52) | 0.00 |
Sex: | |||||
Male | 22(39.3) | 1 | 1 | ||
Female | 34(60.7) | 1.36(0.74–2.5) | 0.32 | 1.12(0.56–2.24) | 0.75 |
Types of diabetes: | |||||
Type I | 22(39.3) | 1 | 1 | ||
Type II | 34(60.7) | 1.72(0.94–3.15) | 0.08 | 2.44(1.16–5.11) | 0.02 |
Duration of diabetes (years): | |||||
< 5 | 14(25) | 1 | 1 | ||
5–10 | 20(35.7) | 0.99(0.46–2.16) | 0.99 | 1.66(0.69–4.04) | 0.26 |
≥ 10 | 22(39.3) | 1.18(0.55–2.53) | 0.67 | 2.06(0.81–5.28) | 0.13 |
Blood glucose level: | |||||
< 126 mg/dl | 21(37.5) | 1 | 1 | ||
≥ 126 mg/dl | 35(62.5) | 1.14(0.62–2.11) | 0.67 | 0.87(0.87–1.75) | 0.69 |
History of previous UTI: | |||||
Yes | 32(57.1) | 4.91(2.61–9.24) | 0.00 | 2.87(1.16–7.08) | 0.02 |
No | 24(42.9) | 1 | 1 | ||
History of previous antibiotic | |||||
Yes | 40(71.4) | 1 | 1 | ||
No | 16(28.6) | 0.21(0.11–0.4) | 0.00 | 0.39(0.16–0.96) | 0.04 |
Antibiotic susceptibility pattern of bacterial isolates
Bacterial Isolates | Patterns | APM | AMC | SXT | GEN | CPR | CTX | CPZ | CRO | NIT | TOB | AMK |
---|---|---|---|---|---|---|---|---|---|---|---|---|
No. | No. | No. | No. | No. | No. | No. | No. | No. | No. | No. | ||
E.coli (n = 13) | S | 1(7.7) | 5(38.5) | 10(76.9) | 10(76.9) | 10(76.9) | 11(84.6) | 11(84.6) | 11(84.6) | 13(100) | 12(92.3) | 12(92.3) |
R | 12(92.3) | 8(61.5) | 3(23.1) | 3(23.1) | 3(23.1) | 2(15.4) | 2(15.4) | 2(15.4) | 0(0) | 1(7.7) | 1(7.7) | |
K.pneumoniae (n = 2) | S | 0(0) | 1(50) | 1(50) | 2(100) | 1(50) | 2(100) | 1(50) | 2(100) | 1(50) | 2(100) | 2(100) |
R | 2(100) | 1(50) | 1(50) | 0(0) | 1(50) | 0(0) | 1(50) | 0(0) | 1(50) | 0(0) | 0(0) | |
P.mirabilis (n = 2) | S | 1(50) | 1(50) | 1(50) | 1(50) | 2(100) | 2(100) | 2(100) | 2(100) | 2(100) | 2(100) | 2(100) |
R | 1(50) | 1(50) | 1(50) | 1(50) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | |
Enterobacter spp. (n = 2) | S | 0(0) | 1(50) | 1(50) | 1(50) | 2(100) | 2(100) | 2(100) | 2(100) | 2(100) | 2(100) | 2(100) |
R | 2(100) | 1(50) | 1(50) | 1(50) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | |
Citrobacterspp. (n = 1) | S | 1(100) | 1(100) | 1(100) | 1(100) | 1(100) | 1(100) | 1(100) | 1(100) | 1(100) | 1(100) | 1(100) |
R | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | |
Total (n = 20) | S | 3(15) | 9(45) | 15(75) | 15(75) | 16(80) | 18(90) | 17(85) | 18(90) | 19(95) | 19(95) | 19(95) |
R | 17(85) | 11(55) | 5(25) | 5(25) | 4(20) | 2(10) | 3(15) | 2(10) | 1(5) | 1(5) | 1(5) |
Bacterial Isolates | Patterns | APM | AMC | SXT | GEN | CPR | P | CTX | CPZ | NIT | VAN |
---|---|---|---|---|---|---|---|---|---|---|---|
No. | No. | No. | No. | No. | No. | No. | No. | No. | No. | ||
CONS (n = 7) | S | 2(28.6) | 6(85.7) | 3(42.8) | 2(28.6) | 6(85.7) | 2(28.6) | 6(85.7) | 6(85.7) | 6(85.7) | NA |
I | 0(0) | 1(14.3) | 1(14.3) | 1(14.3) | 1(14.3) | 0(0) | 1(14.3) | 1(14.3) | 0(0) | NA | |
R | 5(71.4) | 0(0) | 3(42.8) | 4(57.1) | 0(0) | 5(71.4) | 0(0) | 0(0) | 1(14.3) | NA | |
Enterococcus spp. (n = 6) | S | 5(83.3) | NA | NA | NA | 6(100) | NA | NA | NA | 4(66.7) | 5(83.3) |
I | 0(0) | NA | NA | NA | 0(0) | NA | NA | NA | 0(0) | 0(0) | |
R | 1(16.7) | NA | NA | NA | 0(0) | NA | NA | NA | 2(33.3) | 1(16.7) | |
Staphylococcus aureus (n = 4) | S | 0(0) | 3(75) | 3(75) | 3(75) | 4(100) | 0(0) | 3(75) | 3(75) | 4(100) | NA |
I | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | 0(0) | NA | |
R | 4(100) | 1(25) | 1(25) | 1(25) | 0(0) | 4(100) | 1(25) | 1(25) | 0(0) | NA | |
Total (n = 17) | S | 7(41.2) | 9(81.8) | 5(45.5) | 5(45.5) | 15(88.2) | 2(18.8) | 9(81.8) | 9(81.8) | 14(82.1) | 5(83.3) |
I | 0(0) | 1(9.1) | 1(9.1) | 1(9.1) | 1(5.9) | 0(0) | 1(9.1) | 1(9.1) | 0(0) | 0(0) | |
R | 10(58.8) | 1(9.1) | 5(45.5) | 5(45.5) | 1(0) | 9(81.8) | 1(9.1) | 1(9.1) | 3(17.6) | 1(16.7) |
Combination of antibiotics | Total |
E.coli
|
K.pneumoniae
|
P.mirabilis
|
Enterobacter spp.
|
Citrobacter
|
---|---|---|---|---|---|---|
AMP,AMC | 7(14.3) | 5 (11.9) | 1(100) | – | 1(16.7) | – |
AMP,AMC, SXT | 2 (4.1) | 1(2.4) | – | – | 1(16.7) | – |
AMP,AMC, SXT,GEN | 2 (4.1) | 1(2.4) | – | – | 1(16.7) | – |
AMP,AMC, SXT,GEN,CPR, | 1(2) | 1(2.4) | – | – | – | – |
AMP,AMC, SXT,GEN,CPR,CTX | 1(2) | 1(2.4) | – | – | – | – |
AMP,AMC, SXT,GEN,CPR,CTX,CPZ | 1(2) | 1(2.4) | – | – | – | – |
AMP,AMC, SXT,GEN,CPR,CTX,CPZ,CRO | 1(2) | 1(2.4) | – | – | – | – |
AMP,AMC, SXT,GEN,CPR,CTX,CPZ,CRO,TOB | 1(2) | 1(2.4) | – | – | – | – |
AMC, SXT | 2 (4.1) | 1(2.4) | – | – | 1(16.7) | – |
AMC, SXT,GEN | 2 (4.1) | 1(2.4) | – | – | 1(16.7) | – |
AMC, SXT,GEN,CPR | 1(2) | 1(2.4) | – | – | – | – |
AMC, SXT,GEN,CPR,CTX | 1(2) | 1(2.4) | – | – | – | – |
AMC, SXT,GEN,CPR,CTX,CPZ | 1(2) | 1(2.4) | – | – | – | – |
AMC, SXT,GEN,CPR,CTX,CPZ,CRO | 1(2) | 1(2.4) | – | – | – | – |
AMC, SXT,GEN,CPR,CTX,CPZ,CRO,TOB | 1(2) | 1(2.4) | – | – | – | – |
SXT,GEN | 4 (8.2) | 3 (7.1) | – | – | 1(16.7) | – |
SXT,GEN,CPR | 1(2) | 1(2.4) | – | – | – | – |
SXT,GEN,CPR,CTX | 1(2) | 1(2.4) | – | – | – | – |
SXT,GEN,CPR,CTX,CPZ | 1(2) | 1(2.4) | – | – | – | – |
SXT,GEN,CPR,CTX,CPZ,CRO | 1(2) | 1(2.4) | – | – | – | – |
SXT,GEN,CPR,CTX,CPZ,CRO,TOB | 1(2) | 1(2.4) | – | – | – | – |
GEN,CPR | 1(2) | 1(2.4) | – | – | – | – |
GEN,CPR,CTX | 1(2) | 1(2.4) | – | – | – | – |
GEN,CPR,CTX,CPZ | 1(2) | 1(2.4) | – | – | – | – |
GEN,CPR,CTX,CPZ,CRO | 1(2) | 1(2.4) | – | – | – | – |
GEN,CPR,CTX,CPZ,CRO,TOB | 1(2) | 1(2.4) | – | – | – | – |
CPR,CTX | 1(2) | 1(2.4) | – | – | – | – |
CPR,CTX,CPZ | 1(2) | 1(2.4) | – | – | – | – |
CPR,CTX,CPZ,CRO | 1(2) | 1(2.4) | – | – | – | – |
CPR,CTX,CPZ,CRO,TOB | 1(2) | 1(2.4) | – | – | – | – |
CTX,CPZ | 1(2) | 1(2.4) | – | – | – | – |
CTX,CPZ,CRO | 1(2) | 1(2.4) | – | – | – | – |
CTX,CPZ,CRO,TOB | 1(2) | 1(2.4) | – | – | – | – |
CPZ,CRO | 1(2) | 1(2.4) | – | – | – | – |
CPZ,CRO,TOB | 1(2) | 1(2.4) | – | – | – | – |
CRO,TOB | 1(2) | 1(2.4) | – | – | – | |
Total | 49 (100) | 42 (100) | 1(100) | – | 6(100) | – |
Combination of antibiotics | Total | CONS |
Enterococcus
|
S.aureus
|
---|---|---|---|---|
AMP,AMC | 1(5.9) | – | – | 1 (6.7) |
AMP,AMC,GEN | 1(5.9) | – | – | 1 (6.7) |
AMP,AMC,GEN,P | 1(5.9) | – | – | 1 (6.7) |
AMC,GEN,P | 1(5.9) | – | – | 1 (6.7) |
SXT,GEN | 1(5.9) | 2 (66.7) | – | 1 (6.7) |
SXT,GEN,P | 2 (17.8) | 1 (33.3) | – | 1 (6.7) |
GEN,CPR | 1(5.9) | – | – | 1 (6.7) |
GEN,CPR,P | 1(5.9) | – | – | 1 (6.7) |
GEN,CPR,P,CTX, | 1(5.9) | – | – | 1 (6.7) |
GEN,CPR,P,CTX,CPZ | 1(5.9) | – | – | 1 (6.7) |
CPR,P,CTX | 1(5.9) | – | – | 1 (6.7) |
CPR,P,CTX,CPZ | 1(5.9) | – | – | 1 (6.7) |
P,CTX | 1(5.9) | – | – | 1 (6.7) |
P,CTX,CPZ | 1(5.9) | – | – | 1 (6.7) |
CTX,CPZ | 1(5.9) | – | – | 1 (6.7) |
NIT,VAN | 1(5.9) | – | 1(100) | – |
Total | 17 (100) | 3 (100) | 1(100) | 15 (100) |