Microbiological analysis of complicated urinary tract infections in a specialised urology unit in KwaZulu-Natal Province, South Africa, 2021 - 2023
Abstract
Background: Complicated urinary tract infections (cUTIs) are a growing burden in urological patients, particularly those with prior catheterisation or surgical procedures. Appropriate empirical antimicrobial therapy is an essential component in the management of these patients; therefore, treatment guidelines need to be reviewed periodically.
Objectives: To evaluate the microbiological causes and antimicrobial resistance (AMR) patterns of cUTIs in a specialised urology department in KwaZulu-Natal Province, South Africa.
Method: A retrospective study was conducted on all positive urine cultures of patients attending a urology clinic and ward from 1 January 2021 to 31 December 2023. Samples were processed according to standard operating procedures.
Results: A total of 820 specimens were analysed in this study. Escherichia coli was the most common causative agent of cUTIs, accounting for 47% of all isolates, followed by Klebsiella spp. (15%). Enterococcus spp. was the most prevalent Gram-positive uropathogen. Notably, high resistance patterns were observed, with ciprofloxacin resistance rates of 79.4% in E. coli and 50.8% in Klebsiella spp. Extended-spectrum beta-lactamase-producing bacteria were detected in 43.3% of E. coli and 40.2% of Klebsiella spp. isolates, while carbapenem resistance was detected in 15.3% of Klebsiella spp.
Conclusion: Our study shows the importance of antibiotic surveillance to guide empirical antimicrobial therapy based on local microbiological data.…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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