Bacteriological profiles of urinary tract infections in patients admitted to the nephrology-haemodialysis department of the Bogodogo University Teaching Hospital (CHU B), Ouagadougou, Burkina Faso Profils bactériologiques des infections urinaires chez les patients admis au service de néphrologie-hémodialyse du CHU de Bogodogo (CHU B), Ouagadougou, Burkina Faso

Abstract

Background: Urinary tract infections (UTI) constitute a major public health problem, especially in developing countries such as Burkina Faso. They are commonly encountered in hospitals, particularly in patients suffering from chronic kidney disease whose management requires special measures to avoid treatment failures which are frequent. The objective of this study is to determine the microbial profiles of urinary tract infections (UTIs) in these patients.
Methodology: This was a cross-sectional study of hospitalized patients with UTIs in the nephrology-haemodialysis department of the CHUB from August 1 to November 31, 2020. Socio-demographic and clinical data of selected patients were collected by a well-designed data collection form. Cytobacteriological analysis of urine (CBAU) was carried out on voided or catheter-urine sample of each patient using standard microbiological technique. The disc diffusion method in agar medium modified according to the recommendations of the 2020 CA-SFM-EUCAST was used to determine the antibiotic susceptibility of each isolate. Data were processed and analyzed using Excel 2013, IBM SPSS Statistics 25.0 and CSpro 7.5 software.
Results: Urine samples were collected from a total of 77 eligible participants, 49 (63.6%) of which were CBAU positive, with 56 microbial pathogens isolated. Enterobacterales represented 58.9% (n=33), including 39.4% Escherichia coli (n=13) and 36.4% Klebsiella spp (n=12). Non-fermentative Gram-negative bacilli represented 7.1% (n=4) including Acinetobacter baumannii (n=3) and Pseudomonas aeruginosa (n=1). Staphylococcus aureus was isolated in 5.4% (n=3) and Candida spp in 28.6% (n=16). The most active antimicrobials in vitro against the bacterial pathogens were amikacin and imipenem, and clotrimazole and nystatin against the Candida spp. A total 35.7% (n=20)
were multi-drug resistant bacteria with 32.1% by ESBL in Gram-negative bacteria and 66.7% (2/3) by MRSA in Grampositive bacteria.
Conclusion: The high resistance of pathogens to antimicrobials, resulting in therapeutic failures, constitutes a significant challenge in the management of urinary tract infection, especially in people with chronic kidney disease. It is therefore necessary to put in place urgent measures aimed at the rational use of antimicrobials and strict compliance with good hospital hygiene practices.