Abstract:
Background: Urinary tract infection has been implicated as the most common bacterial
infections in clinical practices and accounts one-third of all infections seeks medical care. The
emergence and spread of Carbapenem-resistant Gram-negative uropathogens poses a serious
threat to human health worldwide. Therefore, identifying the prevalent types of bacteria and
associated factors is essential for better managements of patients and prevention of antibiotic
resistance in the study area.
Objective: The aim of this study was to determine Prevalence of Carbapenem resistant Gram
negative uropathogens and its associated factors among urinary tract infection suspected patients
attending Arba Minch General Hospital, Arba Minch, Southern Ethiopia.
Method: Institutional based cross sectional study was conducted among 422 urinary tract
infection suspected patients attending at Arba Minch General Hospital from 1st June to 30th
August 2020. Midstream urine specimen was collected using sterile wide mouthed urine cup and
inoculated into MacConkey media. Biochemical tests were performed to identify types of
uropathogens. Antimicrobial resistance pattern of Carbapenem and commonly used antibiotics
were assessed using disk diffusion technique and potential carbapenemase enzyme producers
were confirmed by mCIM. Data were entered and analyzed using SPSS version 26. P-value were confirmed by mCIM. Data were entered and analyzed using SPSS version 26. P-value
<0.05 was considered as statistical significant.
RESULT: A total of 422 adult patients were included in this study. 54.7% (231/422) were
females. The mean age of the study participants was 39.99(SD +16.88) years and the range of
age was 18-90 years. The prevalence of Carbapenem resistant Gram negative uropathogen was
17/131(12.98 %( 95% CI (7.0, 19.0). Of which 64.7 %( n=11) were Carbapenemase enzyme
producing uropathogen and Klebsiella spp (n=5) were predominant Carbapenemase enzyme
producer followed by pseudomonas spp (n=4). Participants who had previous antibiotic usage in
last 6 months (p< 0.048), presence of chronic disease (p<0.033), and Hospitalization (p<0.031)
were statically associated with the prevalence of Carbapenem resistant Gram negative
uropathogens. High drug resistance (94.7%) was observed against Ampicillin whereas low
resistance (3.8%) was seen in Impenem. Carbapenemase enzyme producers were 100% resistant
to all antibiotics tested except Nitrofurantion.
Conclusion: The prevalence of carbapenem resistant Gram negative uropathogens in this
study was high and majority of carbapenem resistant isolates were carbapenemase enzyme
producer. Hospitalization, antibiotics usage with in last 6 months and presence of chronic
underlying disease were significant for Carbapenem resistant uropathogens.
