PREVALENCE OF CARBAPENEM RESISTANT GRAM NEGATIVE UROPATHOGENS AND ITS ASSOCIATED FACTORS AMONG URINARY TRACT INFECTION SUSPECTED PATIENTS ATTENDING AT ARBA MINCH GENERAL HOSPITAL, ARBA MINCH, SOUTHERN ETHIOPIA

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.