The sensitivities to first-line antibiotic therapy of the common urinary tract bacterial infections detected in urine samples at a hospital in metropolitan Kampala (Uganda)
Background: Urinary tract infections (UTIs) are among the most common
human infections. Many urinary tract bacteria are capable of expressing
drug resistance. Resistant bacteria may be present from the
commencement of the infection or may develop during treatment. This
study focused on the problem of antibiotic resistance to the first-line
drugs that were used to treat patients presenting with urinary tract
infections at Rubaga hospital in Kampala, Uganda. Objectives: The
objective of this study was to isolate and identify the major bacterial
pathogens of symptomatic and asymptomatic UTIs among patients at Rubaga
hospital. Furthermore, the study sought to determine the antimicrobial
susceptibility patterns of the major bacterial isolates to the
first-line drugs used to treat UTIs at Rubaga hospital. Methods: Urine
samples were aseptically collected and examined microscopically and
were microbiologically cultured on blood agar, nutrient agar and on
MacConkey agar. The isolates obtained were then identified using
standard tests and tested for antimicrobial sensitivity by the
Kirby-Bauer technique. Results: The isolated pathogens included
Escherichia coli (10.9%), Staphylococcus (31.9%), Streptococcus
(9.2%), Klebsiella species (21.0%) and Proteus species (10.1%). 20
(16.8%) of the isolates were lactose fermenting gram-negative rods that
were also indole-negative. These isolates were termed `unclassified
coliforms' in this study but were probably Enterobacter species. On
antimicrobial susceptibility testing, all the gram-negative isolates
were significantly resistant to amoxycillin, cotrimoxazole,
erythromycin, and to nalidixic acid; but were susceptible to
nitrofurantoin. Among the gram-negative isolates, only Klebsiella
species were significantly resistant (p<0.05) to ciprofloxacin. The
gram-positive cocci were susceptible to amoxycillin, ciprofloxacin, and
to erythromycin but resistant to cotrimoxazole and nalidixic acid.
Unlike the Staphylococcus species that were significantly resistant to
nitrofurantoin, Streptococcus species were moderately susceptible to
the drug. Conclusion: The common urinary tract bacteria detected in
Rubaga hospital in Uganda were most sensitive to Ciprofloxacin and
Nitrofurantoin