Antibiogram Audit of Catheter-associated Uropathogenic Isolates in University of Calabar Teaching Hospital, Calabar, Nigeria: Advocating Laboratory-based Prescription Practices
G. I. Ogban *
Department of Medical Microbiology and Parasitology, University of Calabar, Calabar, Nigeria.
A. A. Iwuafor
Department of Medical Microbiology and Parasitology, University of Calabar, Calabar, Nigeria.
U. E. Emanghe
Department of Medical Microbiology and Parasitology, University of Calabar, Calabar, Nigeria.
S. N. Ushie
Department of Medical Microbilogy and Parasitology, Nnamdi Azikiwe University, Awka, Nigeria.
E. M. Bisong
Department of Family Medicine, University of Calabar, Calabar, Nigeria.
S. N. Okonkwo
Department of Ophthalmology, University of Calabar, Calabar, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: The most important risk factor to developing UTI is the presence of an indwelling urethral catheter. Eighty percent of nosocomial UTI was reported to be caused by urethral catheterization. UTIs in health care institutions and in those with frequent antibiotic exposures were frequently caused by multi- drug resistant pathogens. This study sought to determined the antibiogram of isolates from catheterized patients with UTIs with a view to establishing if there were justifications for empiric treatment of this condition in the study area in the absence of quality antibiotic formulary.
Materials and Methods: Interviewer administered questionnaires were used to collect socio-demographic data. Specimens were cultured on 5% sheep blood agar (SBA), MacConkey and sabouraud dextrose agar plates and incubated at 37°c for 24 hours in ambient air. Significant bacteriuria was determined on growths from SBA. Growths were identified using standard biochemical techniques.
Results: The study established 74.3% (52) prevalence of CAUTIs amongst catheterized patients in the study area with 29 (41.4%) female dominance. Imipenem (93.9%) recorded the highest percentage susceptibility, followed by Amikacin (91.8%) and Piperacillin/ tazobactam (88.8%). E. coli 17(32.7%) was the dominant isolate. Extended spectrum β-lctamase prevalence was 23(44.2%) and MRSA 2(3.8%). There was significant statistical relation between ESBL production and resistance to other classes of antibiotics.
Conclusion: There is high percentage prevalence of multidrug resistance (MDR) among isolates of CAUTIs in the study area. We therefore advocate laboratory based prescription practice and de-emphasized empiric treatment pending when there would be in a quality drug formulary founded on regular resistance surveillance.
Keywords: Antimicrobial audit, catheter-associated, prescription practice, empiric treatment.