Antimicrobial Susceptibility Profile of Urinary Tract Pathogenic Infections in Diabetic Patients Attending a Health Facility in Kumasi, Ghana

Abstract

Aims: This study seeks to investigate the antimicrobial susceptibility profile of urinary tract pathogenic infections in diabetic patients attending a health facility in Kumasi, Ghana. Study Design: A total of 285 patients were recruited using Cochran’s formula at a prevalence of 26.4% for this study from patients attending the University Hospital from April 2018 to October 2018. Data were collected using a structured questionnaire. Methodology: Clean-catch midstream urine samples were screened for the presence of pathogenic bacteria and their antimicrobial susceptibility pattern using recommended culture methods. Results: Out of the 285 patients, 125 (43.9%) were diabetic with 90 (72%) being female and 35 (28%) male. There was no association between UTI’s and gender (P=0.5799) with diabetic patients recording higher bacteriuria compared to non-diabetics (P< 0.001). Isolates from 113 (39.4%) of the samples were identified and these included, Escherichia coli, Pseudomonas species, Klebsiella species, Proteus species and Staphylococcus aureus. The most predominant was E. coli 62 (54.9%) followed by S. aureus 24 (21.2%), Klebsiella species 14(12.4%), Pseudomonas species 12(10.6%) and Proteus species 1(0.9%). E. coli showed a high antimicrobial sensitivity rates against most of the tested antibiotics, gentamycin (90.3%), amikacin (98.4%), nalidixic (34%), cefotaxime (80.6%) and nitrofurantoin (93%). Proteus spp. on the other hand, showed a 100% sensitivity to all the antibiotics except tetracycline, amikacin and cefotaxime. It was observed that Escherichia coli was mostly resistant to tetracycline (96.8%), norfloxacin (69.4%) and cefotaxime (61.4%). Conclusion: S. aureus showed a higher level of resistance to tetracycline (100%). The prevalence of this study indicated that UTI among diabetic patients was relatively comparable with other studies. Amikacin and nitrofurantoin should be recommended as antimicrobials for the treatment of UTIs whilst the use of tetracycline, norfloxacin and cefotaxime should be discouraged.