Epidemiology and antimicrobial resistance trends of pathogens causing urinary tract infections in Mwanza, Tanzania: A comparative study during and after the implementation of the National Action Plan on Antimicrobial Resistance (2017-2022)
Abstract
OBJECTIVES: To delineate the epidemiology and antimicrobial resistance (AMR) trends of pathogens causing urinary tract infections (UTIs) during (June 2019-June 2020) and after (March-July 2023) the implementation of the National Action Plan on AMR 2017-2022 in Mwanza, Tanzania.
METHODS: This cross-sectional study was conducted among 2097 patients with clinical symptoms of UTIs during (n = 1144) and after (n = 953) the National Action Plan on AMR 2017-2022. Quantitative urine culture was done to isolate significant bacteria causing UTI, which were then identified to the species level and tested for antimicrobial susceptibility. Tabulations, descriptive, and logistic regression analyses were used to analyze categorical and continuous variables, as well as the association between outcome and independent variables. Statistical significance was defined as P ≤0.05 at a 95% confidence interval (CI).
RESULTS: The overall prevalence of culture-positive UTIs was 22.8% (479 of 2097; 95% CI: 21.1-24.7%), with no significant difference between the study periods (21.8% [249 of 1144; 95% CI: 19.5-24.3%]) vs 24.1% (230 of 953; 95% CI: 21.5-26.9%), P = 0.274). We observed a significant increase in resistance to ciprofloxacin (32.0% vs 45.8%, P = 0.0481) and third-generation cephalosporins (marked by extended-spectrum β-lactamase-producing Enterobacterales [ESBL-PE], 38.7% vs 56.9%, P = 0.0307). Additionally, UTIs caused by ESBL-PE is significantly common among patients in higher-tier…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 2,097 participants or records.
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