Bacterial profile and antimicrobial susceptibility pattern of urinary tract infection among diabetic patients at Bule Hora University Teaching Hospital, Southern Ethiopia

Urinary tract infections (UTIs) are among the most common infectious diseases in both hospital and community settings, leading to increased morbidity and mortality, particularly in patients with DM due to impaired immune function and hyperglycemia. The rise of antimicrobial resistance (AMR) further complicates the treatment of bacterial uropathogens, presenting a significant public health challenge. Thus, this study aimed to assess the magnitude, antimicrobial resistance patterns, and risk factors of bacterial UTIs in DM patients at Bule Hora University Teaching Hospital, Southern Ethiopia, 2023. An institution-based cross-sectional study was conducted among 249 DM patients, selected via systematic random sampling, from July 1 to August 30, 2023. Sociodemographic and clinical data were gathered using a pretested structured questionnaire. Midstream urine samples were collected for bacterial culture and identification following standard microbiological procedures, with antimicrobial susceptibility testing performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Data were entered into EpiData version 4.6 and analyzed using IBM SPSS Statistics 17. Frequencies and percentages were used to summarize the data, while logistic regression models were utilized to establish the relationship between dependent and independent variables. A P-value <= 0.05 at a 95% confidence interval was considered statistically significant. The prevalence of bacterial UTIs among DM patients was found to be 15.7%. E. coli was the most common bacterial isolate, accounting for 15/39 (38.5%) of cases, followed by CONS (17.9%) and Klebsiella spp. (15.4%). Gram-negative isolates exhibited high resistance to ampicillin (93.1%) and ampicillin-clavulanic acid (79.3%), while all Gram-positive bacteria were resistant to ampicillin (100%). Furthermore, 17/39 (43.6%) of the isolates were identified as multidrug-resistant. Being female (AOR 2.132, 95% CI 1.044-4.379), a previous history of UTI (AOR 2.520, 95% CI 1.219-5.209), and a duration of DM >= 5 years (AOR 2.30, 95% CI 1.11-4.786) were significantly associated with an increased risk of UTI. This study found a 15.7% prevalence of bacterial UTIs among DM patients, with being female, having a history of UTI, and having longer DM duration as significant risk factors. High resistance to common antimicrobial agents was also observed. Given these results, it is crucial to support the selection of empirical treatments with regular antimicrobial susceptibility testing in the study area to ensure effective management and combat rising resistance.