Understanding local antimicrobial resistance patterns is a baseline step for evidence-based empirical antibioticrnprescribing. Urinary tract infections UTIs are some of the most common infections at the community level. Even thoughrnUTIs are easily treated using antibiotics widespread use of antibiotics without proper susceptibility testing has inevitably ledrnto increased UTI pathogens that are resistant to affordable and available antibiotics. In order to assess the appropriate empiricalrntherapy this study investigated the resistance patterns of main causative agents of UTI in three metropolitan areas.
To determine the resistance patterns of bacteria implicated in UTIs among patients seeking treatment in selectedrnhealthcare facilities in Kenya.
In this mixed methods study 1898 mid-stream urine were collected from patients who presented with UTI-likernsymptoms in the following healthcare facilities KNH Kiambu hospital Mbagathi Makueni Nanyuki CMR labs and Mukururnhealth centres. Cultures were done on CLED to identify the main uropathogens and ASTs patterns assed via Kirky Bauer methodrnfor the resistance patterns analysis using disc diffusion method.
Out of 1027 positive urine cultures Staphylococcus spps and E. coli were the main uropathogens at 24 and 15rnrespectively. Average resistance profiles for commonly used UTI drugs was as follows Amoxicillin-clavulanic acid10rnCefuroxime13 Cefixime7 Ciprofloxacin26 Nitrofurantoin9 Trimethoprim64 and Sulfamethoxazole57.rnAdditionally resistance to other broadspectrum antimicrobials such as Cefriaxone Ceftazidime and Getamicin was at 11 15rnand 14 respectively. Cefixime and Amoxicillin Clavulanic Acid were the most effective agents against these isolates whilernTrimethoprim sulfamethoxazole and Nalidixic Acid were the most resisted antibiotics.
High resistance rates were reported in Quinolones and Sulfamethoxazole Trimethoprim which are the commonlyrnused drugs as they are cheap to buy and readily available. Empirical antibiotic selection for UTI should be based on knowledgernof the local prevalence of uropathogens and their antibiotic resistance patterns found on the policy briefs and MOH guidelinesrnbecause resistance patterns may vary in different regions.