Burden of multi-drug resistant bacterial isolates and its associated risk factors among UTI-confirmed geriatrics in Gondar town
Getachew Bitew, Mulat Dagnew, Mahliet Dereje, Abebe Birhanu, Yalewayker Gashaw, Aklilu Ambachew, Belay Tessema
Abstract
Multi-drug resistant (MDR) bacterial urinary tract infection (UTI) is a significant health threat in the geriatric population, with limited data in this study area. Therefore, this study aimed to assess the burden of MDR bacterial isolates and associated risk factors among UTI-confirmed geriatrics in Gondar, providing essential information for geriatric patients, healthcare workers, scientists, and policymakers to guide antibiotic stewardship interventions. A prospective cross-sectional study was conducted among 204 UTI-confirmed geriatrics. Socio-demographic data were collected via a structured questionnaire, and bacterial identification and drug resistance testing followed standard microbiological techniques. Data were entered using Epi Data version 4.0.0 and analyzed by Stata/IC version 14.0, with bivariate and multivariate logistic regressions to identify risk factors. A P-value < 0.05 was considered statistically significant. The overall prevalence of MDR UTI-confirmed geriatrics and MDR bacterial isolates were 115 (56.4%) and 126 (49.6%), respectively. The MDR Gram-negative isolates accounted for 105 (83.3%), and Gram-positive isolates 21 (16.7%). The predominant MDR bacterium was E. coli 60 (47.6%), followed by K. pneumoniae 24 (19.1%), S. aureus 13 (10.3%), P. mirabilis and S. saprophyticus 8 (6.4%), Pseudomonas spp. 6 (4.8%), P. vulgaris 4 (3.2%) and K. rhinos 3 (2.4%). Extensive (XDR) and pan-drug resistant (PDR) isolates were 63 (24.8%) and 6 (4.8%), respectively. Risk factors such as recurrent UTI, hospitalization (≥ 4 days), antibiotic and urinary catheter use were statistically significant. This study found a high prevalence of MDR bacterial isolates in UTI-confirmed geriatrics, with most isolates resistant to tetracycline, beta-lactams, and quinolones. Escherichia coli was the most common MDR and XDR bacteria, while Pseudomonas was the only PDR isolate. Independent risk factors included recurrent UTI, hospitalization (≥ 4 days), antibiotic and urinary catheter use. Therefore, efforts should focus on reducing hospital stays, promoting rational drug use, and further research.