Antimicrobial Susceptibility Patterns Of Enterobacteriaceae Isolated From Urine Samples At The Kenyatta National Hospital Microbiology Laboratory

Abstract

Background: Antimicrobial resistance is an increasingly emerging problem worldwide and is a critical challenge for infectious diseases management around the world.Data from the National Healthcare Safety Network indicate that gram-negative bacteria are responsible for more than 30% of hospital-acquired infections and more than 40% of infections in patients in intensive care units. These infections are difficult to manage translating to a higher rate of morbidity and mortality as well as prolonged length of hospital and intensive care unit stay as well as increased expenses for the healthcare systems. Methods: This was a hospital based cross sectional descriptive survey aimed at identifying antimicrobial susceptibility patterns of the Enterobacteriaceae isolated from urine sampled from both inpatients and outpatients in KNH microbiology laboratory in the period January 2012 to December 2012.Data were retrieved from the archives.A coded form was used to abstract the data. The study was approved by the KNH / U.o.N Ethics and Research Committee. Results: In this study, among both sexes tested, incidence of Enterobacteriaceae infections was higher in females (56%) than males (44%). Enterobacteriaceae isolated were: E.coli (46%), Klebsiella spp. (19.5%), Citrobacter spp. (15.9%), Proteus spp. (7.1%), Enterobacter spp. (5.8%), Acinetobacter spp. (5.5%). Tested Carbapenems were found to have better activity against majority of the isolates. ESBL production was found to be high (>60%). Conclusion: E. coli was the most common isolate. Tested carbapenems were more effective, than other drugs, against all the isolates. Proteus spp. were the prevalent ESBL producers. Acinetobacter spp. and E. coli showed higher and lower resistance respectively to carbapenems