Antimicrobial Resistance in Uropathogens Associated with Community Acquired Urinary Tracts Infections in Port Harcourt, Nigeria

Abstract

Introduction: Antimicrobial resistance (AMR) in uropathogens remain an intractable public health concern due to the associated mortality, morbidity and economic and manpower losses worldwide. This retrospective study was aimed at ascertaining the prevalence of the bacterial uropathogens and the antimicrobial resistance patterns of the dominant strains. Methodology: It involved a review of laboratory records of the over 1426 males (38%) and females (62%) of various s age brackets between January 1, 2021 and December 31, 2022. Results: Out of 1426 urine culture samples 58.5% were negative cultures while 592 (41.5%) yielded bacterial growths. A total of 403 uropathogens comprising 11 species were obtained. Gram negative bacteria constitute 73.9% of the isolates while gram positive bacteria were 26.1% Escherichia coli (54.7%) was the dominant strains, followed by Staphylococcus aureus (10.3%, Enterococcus faecalis (9.5%), Proteus mirabilis (7.7%, Staphylococcus saprophyticus (5.7%, Streptococcus pneumoniae (3.9%), Klebsiella pneumoniae 17 (3.0%), Pseudomonas aeruginosa (2.7%), Enterobacter cloacae (1.1%), Acinetobacter baumannii (0.9%) and Serratia marcescens (0.5%). A cumulative of 50.5% of the strains were resistant to at least on antimicrobial agent. The most resistant uropathogen  was Pseudomonas aeruginosa with a resistant profile of 64.1%, followed by Klebsiella pneumoniae (63.7%), Staphylococci (55.7%), Streptococcus pneumoniae (55.2%), Acinetobacter baumannii (51.7%), Proteus mirabilis (51.4%), Escherichia coli (48.0%), Enterobacter cloacae (47.1%), Enterococcus faecalis (46.5%) and Serratia marcescens (43.3%) The least effective antimicrobial agent was nitrofurantoin which resisted by 87.1% strains, the most effective was streptomycin (22.2%). Conclusion: This study will benefit healthcare practitioners in the empirical choice of antibiotics against UTI; however, the high prevalence of AMR necessitates conduct of urine cultures to identify particular uropathogens appropriate antimicrobials in other to curtail increase in AMR among uropathogens.