Abstract:
Urinary tract infections (UTIs) are among the most prevalent extra-intestinal
diseases, with alarming prevalences reported globally. Bacterial pathogens, including
uropathogens, use various evolving mechanisms, such as carriage of resistance genes
and biofilm formation, to significantly reduce cidal activity of antimicrobial agents.
This cross-sectional study aimed to isolate & determine the prevalence, selected risk
associated factors, antimicrobial susceptibility profiles, carriage of desired extended
spectrum β-lactamase (ESβLs) genes, and biofilm formation by bacteria causing
urinary tract infections among adult seeking medicare at Kiambu Level 5 hospital,
Kenya. The study used well-structured questionnaires to capture socio-demographic
data among the 206 participants. The prevalence rate of UTIs was 57/206 (27.6%).
Escherichia coli, Staphylococcus aureus, and Klebsiella pneumoniae were the most
prevalent bacterial pathogens at 18/57(31.6%), 14/57(24.5%), and 13/57(22.8%),
respectively. On risk-associated factors, women had a significantly higher prevalence
rate of UTIs at 47/57 (82.4%). The antimicrobial sensitivity analysis revealed high
resistance towards Sulfamethoxazole and Ampicillin at 50% - 85% and resistance
patterns towards Cefotaxime, Ceftriaxone, and Ciprofloxacin below 40%. ESβLs
blaTEM genes genotype was the most prevalent revealed at 10/100 (100%), followed
by blaOXA and blaSHV genes at 4/10 (40%) and 3/10 (30%), respectively. The biofilm
formation finding also disclosed that most of the study isolates were biofilm
formers36/57 (63.2%), with Gram-negative isolates being the most formers of
biofilms 25/36 (69.4%). E. coli 15/36 (41.7 %), Klebsiella sp. 7/36 (19.4%), and S.
aureus 7/36 (19.4%) were the most common biofilm formers. In conclusion, the
carriage of ESβLs and bacteria's ability to form a biofilm may be drivers of
antimicrobial resistance. The study advocates mapping the distribution of ESβLs to
aid in halting antimicrobial resistance and offer support to pharmaceutical industries
with fewer new antibiotics in the pipeline.
