Urinary tract infection in cancer patients and antimicrobial susceptibility of isolates in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

BACKGROUND: Urinary tract infections are the most common causes of morbidity and mortality in patients with cancer. The emergence of multiple-drug-resistant (MDR) strains of gram-negative bacteria causing urinary tract infection has become a serious concern in cancer patients. Therefore, the present study aimed to determine the spectrum and antibiotic resistance pattern of bacterial isolates related to urinary tract infections among cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. METHODS AND MATERIALS: Hospital based prospective cross-sectional study was conducted for three months from January to March 2018 in tertiary care hospital located in the capital city of the country. Gram-negative bacteria isolated from urine specimens from hospitalized patients with cancer were characterized using standard microbiological methods. Modified Kirby-Bauer disk diffusion technique was applied for antimicrobial susceptibility testing in accordance with CLSI 2019 criteria. RESULTS: Of totally 292 urine samples tested, eighteen (6.3%) were culture positive cases, Escherichia coli (44.4%) was the highest proportion isolated uropathogen followed by Klebsiella pneumoniae (22.2%) and Citrobacter diversus (16.7%). The antibiotic susceptibility results showed meropenem and nitrofurantoin as the most effective antibiotics for E. coli, K. pneumoniae, and Citrobacter diversus isolates. The rate of multidrug resistant (MDR) isolates were 33.3% (6/18), and meropenem and nitrofurantoin were the most effective antibiotic against MDR isolates. CONCLUSION: The study findings showed a significant distribution of MDR gram-negative bacteria which may increase the burden of urinary tract associated infections in cancer patients. Carbapenem (meropenem) can be considered as effective agents to treat MDR cases in our region.

Neonatal bacterial meningitis in Tikur Anbessa Specialized Hospital, Ethiopia: a 10-year retrospective review.

BACKGROUND: Bacterial meningitis is still a major public health threat in developing countries. It is an overwhelming infection with a high morbidity and mortality rate, especially in neonates. The aim of this study was to determine the prevalence and etiological agents that cause bacterial neonatal meningitis at Tikur Anbessa Specialized Hospital (TASH). METHODS: This is a retrospective analysis of 1189 cerebrospinal fluid (CSF) specimens submitted to the bacteriology laboratory of TASH for culture from 2001 to 2010. All newborns younger than 29 days old that were suspected for bacterial meningitis cases were included in the study. RESULTS: Based on CSF culture, 56 newborns were identified as having bacterial meningitis from a total of 1189 suspected cases. The overall prevalence of neonatal bacterial meningitis from the total suspected cases was 4.7%. The organisms identified and their prevalence rates were Streptococcus pneumoniae 13 (23%), Escherichia coli 9 (16%), Acinetobacter 7 (13%), Neisseria meningitides 5 (9%), Klebsiella spp. 5 (9%), Staphylococcus aureus 3 (5%) and Streptococcus pyogen 3 (5%). There were two (4%) cases each that was caused by Coagulase-Negative-Staphylococcus and Non-Group-A-Streptococcus, while 1 (2%) caused by Haemophilus influenzae. S. pneumoniae was the main etiological agent identified from CSF culture. The male to female ratio was 1:0.88 (53% were male). The birth weights of 34 (61%) patients were under 2500 g, and 22 (39%) patients had normal birth weights. Twenty-seven (48%) were early onset cases, and 29 (52%) were late-onset. CONCLUSION: Streptococcus pneumoniae and Escherichia coli were the two main etiological agents for neonatal bacterial meningitis infection in the study area.