Abstract:
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ABSTRACT
Background: Urinary tract infection is a common opportunistic infection in HIV/AIDS positive patients
mostly caused by bacteria. However, these bacteria emerging as multidrug resistant and have been on the
rise globally with serious public health concerns.
Objective: The aim of this study was to determine the prevalence of Multi Drug resistant uropathogens
and its associated factors among urinary tract infection suspected HIV positive adult patients attending
Arba Minch general hospital, Arba Minch, Southern Ethiopia 2021.
Methods: Institution based cross sectional study was conducted at Arba Minch General Hospital from 1st
January to 30th April 2021. A total of 251 HIV positive study participants who had clinical suspected of
urinary tract infection was systematically recruited. Socio demographic and clinical data was collected by
pretested structured questionnaire through face-to-face interview. Clean catch mid steam urine sample
was collected, processed and inoculated on CLED, MSA and MacConkey agar. Gram staining and
biochemical test was used to identify the species of bacterial isolates. Antibiogram profile of the isolates
was determined by using modified Kirby Baur disc diffusion technique. The data was entered and
analyzed by SPSS version 21 statistical software. Binary and multivariate logistic regression was applied.
Adjusted odd ratio (AOR) and 95% Confidence Interval (CI) was used to determine the presence and
strength of the association.
Result: Uropathogens isolates from 251 examined urine sample were 39 (15.5%). Of these, 36(92.3%)
were identified as multidrug resistant uropathogens and 3(7.7%) were non multidrug resistant
uropathogens. The overall prevalence of multidrug resistant uropathogens among the study population
was 14.3% (95% CI: (10-19.1)). Gram negative bacteria were the predominant MDR isolates with
E.coli (41.7%) followed by K.pneumoniae (22.2). Antibiotic usage within last 6 months [AOR= 6.7,
95% CI: (2.53-17.6)], presence of chronic underlying disease [AOR= 7.03, 95% CI: (1.72-
28.73)], Use of antibiotics without prescription [AOR= 9.7, 95% CI: (3.53-26.675)] and CD4
Count < 250 cells/ml [AOR= 8.05, 95% CI: (2.078-31.154)] were statistically significant for
MDR uropathogens in multivariate analysis (P<0.05).
Conclusions: The overall prevalence of this study was comparable with other study conducted in
Ethiopia. Gram-negative bacteria were the most common causes of urinary tract infection. All isolates
were 100% resistant to Ampicillin and 70-90% to tetracycline, gentamicin and Nalidixic acid.
Nitrofurantoin, Cefepime, meropenem and Clindamycin were the most effective drugs.
