Characterization of Extended Spectrum Beta-lactamase Uropathogens Isolated from Refugees with Urinary Tract Infections in Nakivale Refugee Settlement Camp, Southwestern Uganda
Ayan Ahmed Hussein
Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Mbarara city, Uganda.
Kennedy Kassaza
Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Mbarara city, Uganda.
James Mwesigye
Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Mbarara city, Uganda.
Nalumaga Pauline Petra
Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Mbarara city, Uganda.
Bashir Mwambi
Department of Medical Laboratory Science, Institute of Allied Health Sciences, Clarke, International University P.O Box 7782 Kampala, Uganda.
Taseera Kabanda
Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Mbarara city, Uganda.
Joel Bazira *
Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Mbarara city, Uganda.
*Author to whom correspondence should be addressed.
Abstract
The World Health Organization estimates one in four individuals has had at least one urinary tract infection (UTI) episode requiring treatment with an antimicrobial agent. At Nakivale refugee camp, the overwhelming number of refugees often associated with poor living conditions predispose the refugees to urinary tract infections.
This study determined the prevalence of UTIs, the antimicrobial susceptibility pattern of the isolated bacterial pathogens, the prevalence of Extended-Spectrum Beta-Lactamase (ESBL) bacteria, and the molecular characterization of genes encoding ESBLs among refugees in the Nakivale refugee settlement.
This was a cross-sectional study that involved 216 outpatients who visited Nakivale Health Centre III between July and September 2020. The urine samples were received and examined at the microbiology laboratory of Mbarara University of Science and Technology. The urine samples were cultured and identified. Antibiotic susceptibility was carried out following CLSI recommended guidelines while the presence of genes encoding ESBL was detected using conventional PCR amplification.
The prevalence of UTI was 24.1% (52/216). Staphylococcus aureus was the most prevalent causative agent, accounting for 22/52 (42.31%) of total isolates, followed by Escherichia coli 21/52(40.38%). Multidrug-resistant isolates accounted for 71.15% (37/52). A total of twenty-one isolates (70.0%) were extended spectrum beta-lactamase producing bacteria. The most prevalent genes were TEM beta-lactamase (blaTEM) and CTX-M beta-lactamase (blaCTX-M).
The prevalence of UTI among refugees in the Nakivale settlement was high which calls for continuous epidemiological surveys to determine the prevalence of multi-drug resistance uropathogens including ESBL-producing organisms across refugee camps in Uganda.
Keywords: Uropathogens, extended beta-lactamase organisms, nakivale refugee settlement camp