Antimicrobial susceptibility profile of uropathogens in Maluti Adventist Hospital patients, 2011

Background: Urinary tract infections (UTIs) are amongst the most common infections encountered globally and are usually treated empirically based on bacterial resistance to antibiotics for a given region. Unfortunately in Lesotho, no published studies are available to guide doctors in the treatment of UTIs. Treatment protocols for Western countries have been adopted, which may not be applicable for this region. Aim: To determine the antimicrobial susceptibility profile of uropathogens in outpatients at the Maluti Adventist Hospital. Setting: The study was conducted at the outpatient department of the Maluti Adventist Hospital in Mapoteng, Lesotho. Methods: This was a prospective cross-sectional study using consecutive sampling of patients with clinical symptoms of UTI. Midstream urine samples were screened through chemistry and microscopy, then positive urine samples were cultured. The isolated uropathogens underwent antimicrobial susceptibility testing and inclusion continued until 200 culture samples were obtained. Descriptive statistics were used in the data analysis. Results: The top five cultured uropathogens were Escherichia coli (61.5%), Staphylococcus aureus (14%), Pseudomonas species (6.5%), Enterococcus faecalis (5.5%) and Streptococcus agalactiae (5%). The isolated uropathogens showed low sensitivity to cotrimoxazole (32.5% - 75.0%) and amoxicillin (33.2% -87.5%) and high sensitivity to ciprofloxacin (84.0% - 95.1%) and nitrofurantoin (76.9% - 100%) Conclusion: In the Maluti setting, cotrimoxazole and amoxicillin should be avoided as firstline drugs for the empirical treatment of community-acquired UTI. We recommend the use of nitrofurantoin as first choice.