PREVALENCE AND ASSOCIATED FACTORS OF MULTI DRUG RESISTANT UROPATHOGENS AMONG URINARY TRACT INFECTION SUSPECTED HIV POSITIVE ADULT PATIENTS ATTENDING ARBA MINCH GENERAL HOSPITAL, SOUTHERN ETHIOPIA

Abstract

X 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.