| Peer-Reviewed

Epidemiological Profile of Urinary Tract Infections Observed at the Institut Pasteur in Bangui, Central African Republic

Received: 20 February 2022     Accepted: 11 March 2022     Published: 29 March 2022
Views:       Downloads:
Abstract

The urinary tract is the second most common site of bacterial infection after the respiratory tract. Enterobacteria remain the first cause of urinary tract infections (UTIs), followed by staphylococci and non-fermenter bacteria. Furthermore, bacteria producing extended spectrum beta-lactamases (ESBL) have become more frequent, exposing African patients to therapeutic dead ends. The aim of this study was to determine the epidemiological profile of UTIs diagnosed at the Institut Pasteur in Bangui (IPB), Central African Republic (CAR), a research center that carries out antibiotic sensitivity testing according to international standards. For that, the collected demographic, clinical and biological data come from patients calling at the IPB for a urinalysis and who gave their consent for their data to be included and analyzed in this six-month cross-sectional study (January-June 2019). A total of 412 patients were enrolled in this study. The mean age was 35.2 years [1-80], females made up 55.8% of the study population and the sex ratio was 0.79:1 (M: F). Overall, 117 UTIs were detected, giving a prevalence rate of 28.4%. Of the bacterial isolates, 89.8% (105/117) were enterobacteria, of which 52.4% (55/105) were ESBL-producers. Escherichia coli accounted for more than half of the isolates 55.5% (65/117) and the ESBL-producers 58.2% (32/55). The 0–15-year age group showed the highest incidence of UTIs, but this rate was not significantly different from the other age groups (P = 0.665). Antecedent UTI was not a significant factor in the observed infections. However, female gender, fever, painful urination, acquisition in a healthcare setting and samples collected outside the laboratory were all significantly associated with UTI cases (P<0.005). The high proportion of ESBL-producing bacteria found during this study poses a real potential threat for public health in the CAR. Controlling antibiotic use should thus be a priority for the Ministry of Health.

Published in American Journal of Biomedical and Life Sciences (Volume 10, Issue 2)
DOI 10.11648/j.ajbls.20221002.15
Page(s) 36-41
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

UTI, Epidemiology, ESBL, Bangui

References
[1] Lee, CY., Chen, PY., Huang, FL., & Lin, CF. (2009). Microbiologic spectrum and susceptibility pattern of clinical isolates from the pediatric intensive care unit in a single medical center – 6 years’ experience. Journal of microbiology, immunology and infection, 42 (2), 160-165. PMID: 19597649.
[2] Nzalie, RN., Gonsu, HK., & Koulla-Shiro, S. (2016). Bacterial etiology and antibiotic resistance profile of community-acquiered urinary tract infection in a cameroonian city. International journal of microbiology, 3240268. doi: 10.1155/2016/3240268.
[3] Alemu, A., Moges, F., Shiferaw, Y., Tafess, K., Kassu, A., & Anagaw, B. et al. (2012). Bacterial profile and drug susceptibility pattern of urinarry tract infection in pregnant women at University of Gondar teaching hospital, northwest Ethiopia. BMC research notes, 25 (5), 197. doi: 10.1186/1756-0500-5-197.
[4] Oli, AN., Akabueze, VB., Ezeudu, CE., Eleje, GU., Ejiofor, OS., & Ezebialu, IU. et al. (2017). Bacteriology and Antibiogram of Urinary Tract Infection Among Female Patients in a Tertiary Health Facility in South Eastern Nigeria. The open microbiology journal, 31 (11), 292-300. doi: 10.2174/1874285801711010292.
[5] Flores-Mireles, AL., Walker, JN., Caparon, M., & Hultgren, SJ. (2015). Urinary tract infections: Epidemiology, mechanisms of infection and treatment options. Nature reviews. Microbiology, 13 (5), 269- 284. doi: 10.1038/nrmicro3432.
[6] Foxman, B. (2014). Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infectious disease clinics of North America, 28 (1), 1-13. doi: 10.1016/j.idc.2013.09.003.
[7] Okarska-Napierała, M., Wasilewska, A., & Kuchar, E. (2017). Urinary tract infection in children: Diagnosis, treatment, imaging - Comparison of current guidelines. Journal of pediatric urology, 13 (6), 567-573. doi: 10.1016/j.jpurol.2017.07.018.
[8] Nicolle, LE. (2013). Urinary tract infection. Critical care clinics, 29 (3), 699-715. doi: 10.1016/j.ccc.2013.03.014.
[9] Mitiku, E., Amsalu, A., & Tadesse, BT. (2018). Pediatric Urinary Tract Infection as a Cause of Outpatient Clinic Visits in Southern Ethiopia: A Cross Sectional Study. Ethiopian journal of health sciences, 28 (2), 187-196. doi: 10.4314/ejhs. v28i2.10.
[10] De Toro-Peinado, I., Concepción Mediavilla-Gradolph, M., Tormo-Palop, N., & Palop-Borrás, B. (2015). Microbiological diagnosis of urinary tract infections. Enfermedades infecciosas y microbiologia clinica, 33 (2), 34-39. doi: 10.1016/S0213-005X(15)30013-6.
[11] Marques, LP., Flores, JT., Barros Junior Ode, O., Rodrigues, GB., Mourão, C de M., & Moreira, RM. (2012) Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women. The Brazilian journal of infectious disease, 16 (5), 436-441. doi: 10.1016/j.bjid.2012.06.025.
[12] Lee, DS., Lee, SJ., & Choe, HS. (2018). Community-Acquired Urinary Tract Infection by Escherichia coli in the Era of Antibiotic Resistance. Biomed research international, (26) 2018, 7656752.
[13] Bercion, R., Mossoro-Kpinde, D., Manirakiza, A., & Le Faou, A. (2009). Increasing prevalence of antimicrobial resistance among Enterobacteriaceae uropathogens in Bangui, Central African Republic. Journal of infection in developing countries, 3 (3): 187-190. doi: 10.3855/jidc.34.
[14] Ronald, A. The etiology of urinary tract infection: traditional and emerging pathogens. Disease-a-month, 49 (2), 71-82. doi: 10.1067/mda.2003.8.
[15] Hailaji, NSM., Ould Salem, ML., & Ghaber, SM. (2016). Sensitivity to antibiotics uropathogens bacteria in Nouakchott Mauritania. Progrès en urologie, 26 (6), 346-352. doi: 10.1016/j.purol.2016.04.004.
[16] Alabi, AS., Frielinghaus, L., Kaba, H., Kösters, K., Huson, MA., & Kahl, BC et al. (2013). Retrospective analysis of antimicrobial resistance and bacterial spectrum of infection in Gabon, Central Africa. BMC infectious disease, (2) 13, 455. doi: 10.1186/1471-2334-13-455.
[17] Rafaï, C., Frank, T., Manirakiza, A., Gaudeuille, A., Mbecko, JR., & Nghario, L. et al. (2015). Dissemination of IncF-type plasmids in multiresistant CTX-M-15-producing Enterobacteriaceae isolates from surgical-site infections in Bangui, Central African Republic. BMC microbiology, 15 (1), 15. doi: 10.1186/s12866-015-0348-1.
[18] Farra, A., Frank, T., Tondeur, L., Bata, P., Gody, JC., & Onambele, al. (2016). High rate of faecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae in healthy children in Bangui, Central African Republic. Clinical microbiology and infection, 22 (10), 891. e1-891.e4. doi: 10.1016/j.cmi.2016.07.001.
Cite This Article
  • APA Style

    Alain Farra, Sylvanus Mogalama, Christian Diamant Mossoro-Kpinde, Gilles Ngaya, Jean Robert Mbecko, et al. (2022). Epidemiological Profile of Urinary Tract Infections Observed at the Institut Pasteur in Bangui, Central African Republic. American Journal of Biomedical and Life Sciences, 10(2), 36-41. https://doi.org/10.11648/j.ajbls.20221002.15

    Copy | Download

    ACS Style

    Alain Farra; Sylvanus Mogalama; Christian Diamant Mossoro-Kpinde; Gilles Ngaya; Jean Robert Mbecko, et al. Epidemiological Profile of Urinary Tract Infections Observed at the Institut Pasteur in Bangui, Central African Republic. Am. J. Biomed. Life Sci. 2022, 10(2), 36-41. doi: 10.11648/j.ajbls.20221002.15

    Copy | Download

    AMA Style

    Alain Farra, Sylvanus Mogalama, Christian Diamant Mossoro-Kpinde, Gilles Ngaya, Jean Robert Mbecko, et al. Epidemiological Profile of Urinary Tract Infections Observed at the Institut Pasteur in Bangui, Central African Republic. Am J Biomed Life Sci. 2022;10(2):36-41. doi: 10.11648/j.ajbls.20221002.15

    Copy | Download

  • @article{10.11648/j.ajbls.20221002.15,
      author = {Alain Farra and Sylvanus Mogalama and Christian Diamant Mossoro-Kpinde and Gilles Ngaya and Jean Robert Mbecko and Hugues Sanke-Waïgana and Alexandre Manirakiza},
      title = {Epidemiological Profile of Urinary Tract Infections Observed at the Institut Pasteur in Bangui, Central African Republic},
      journal = {American Journal of Biomedical and Life Sciences},
      volume = {10},
      number = {2},
      pages = {36-41},
      doi = {10.11648/j.ajbls.20221002.15},
      url = {https://doi.org/10.11648/j.ajbls.20221002.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbls.20221002.15},
      abstract = {The urinary tract is the second most common site of bacterial infection after the respiratory tract. Enterobacteria remain the first cause of urinary tract infections (UTIs), followed by staphylococci and non-fermenter bacteria. Furthermore, bacteria producing extended spectrum beta-lactamases (ESBL) have become more frequent, exposing African patients to therapeutic dead ends. The aim of this study was to determine the epidemiological profile of UTIs diagnosed at the Institut Pasteur in Bangui (IPB), Central African Republic (CAR), a research center that carries out antibiotic sensitivity testing according to international standards. For that, the collected demographic, clinical and biological data come from patients calling at the IPB for a urinalysis and who gave their consent for their data to be included and analyzed in this six-month cross-sectional study (January-June 2019). A total of 412 patients were enrolled in this study. The mean age was 35.2 years [1-80], females made up 55.8% of the study population and the sex ratio was 0.79:1 (M: F). Overall, 117 UTIs were detected, giving a prevalence rate of 28.4%. Of the bacterial isolates, 89.8% (105/117) were enterobacteria, of which 52.4% (55/105) were ESBL-producers. Escherichia coli accounted for more than half of the isolates 55.5% (65/117) and the ESBL-producers 58.2% (32/55). The 0–15-year age group showed the highest incidence of UTIs, but this rate was not significantly different from the other age groups (P = 0.665). Antecedent UTI was not a significant factor in the observed infections. However, female gender, fever, painful urination, acquisition in a healthcare setting and samples collected outside the laboratory were all significantly associated with UTI cases (P<0.005). The high proportion of ESBL-producing bacteria found during this study poses a real potential threat for public health in the CAR. Controlling antibiotic use should thus be a priority for the Ministry of Health.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Epidemiological Profile of Urinary Tract Infections Observed at the Institut Pasteur in Bangui, Central African Republic
    AU  - Alain Farra
    AU  - Sylvanus Mogalama
    AU  - Christian Diamant Mossoro-Kpinde
    AU  - Gilles Ngaya
    AU  - Jean Robert Mbecko
    AU  - Hugues Sanke-Waïgana
    AU  - Alexandre Manirakiza
    Y1  - 2022/03/29
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ajbls.20221002.15
    DO  - 10.11648/j.ajbls.20221002.15
    T2  - American Journal of Biomedical and Life Sciences
    JF  - American Journal of Biomedical and Life Sciences
    JO  - American Journal of Biomedical and Life Sciences
    SP  - 36
    EP  - 41
    PB  - Science Publishing Group
    SN  - 2330-880X
    UR  - https://doi.org/10.11648/j.ajbls.20221002.15
    AB  - The urinary tract is the second most common site of bacterial infection after the respiratory tract. Enterobacteria remain the first cause of urinary tract infections (UTIs), followed by staphylococci and non-fermenter bacteria. Furthermore, bacteria producing extended spectrum beta-lactamases (ESBL) have become more frequent, exposing African patients to therapeutic dead ends. The aim of this study was to determine the epidemiological profile of UTIs diagnosed at the Institut Pasteur in Bangui (IPB), Central African Republic (CAR), a research center that carries out antibiotic sensitivity testing according to international standards. For that, the collected demographic, clinical and biological data come from patients calling at the IPB for a urinalysis and who gave their consent for their data to be included and analyzed in this six-month cross-sectional study (January-June 2019). A total of 412 patients were enrolled in this study. The mean age was 35.2 years [1-80], females made up 55.8% of the study population and the sex ratio was 0.79:1 (M: F). Overall, 117 UTIs were detected, giving a prevalence rate of 28.4%. Of the bacterial isolates, 89.8% (105/117) were enterobacteria, of which 52.4% (55/105) were ESBL-producers. Escherichia coli accounted for more than half of the isolates 55.5% (65/117) and the ESBL-producers 58.2% (32/55). The 0–15-year age group showed the highest incidence of UTIs, but this rate was not significantly different from the other age groups (P = 0.665). Antecedent UTI was not a significant factor in the observed infections. However, female gender, fever, painful urination, acquisition in a healthcare setting and samples collected outside the laboratory were all significantly associated with UTI cases (P<0.005). The high proportion of ESBL-producing bacteria found during this study poses a real potential threat for public health in the CAR. Controlling antibiotic use should thus be a priority for the Ministry of Health.
    VL  - 10
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Medical Laboratory, Institut Pasteur in Bangui, Bangui, Central African Republic

  • Faculty of Health Sciences, University of Bangui, Bangui, Central African Republic

  • Faculty of Health Sciences, University of Bangui, Bangui, Central African Republic

  • Medical Laboratory, Institut Pasteur in Bangui, Bangui, Central African Republic

  • Medical Laboratory, Institut Pasteur in Bangui, Bangui, Central African Republic

  • Department of Epidemiology, Institut Pasteur in Bangui, Bangui, Central African Republic

  • Sections