Urosepsis among Sudanese Patients: A Paradigm from Limited Resources Country

Abstract

Background: Urosepsis is life-threatening sepsis that leads to organ dysfunction and results from a defective response to a urinary tract infection; the major precipitating is obstructive uropathy in the upper or lower urinary tract (UT). The magnitude and burden of bacteria that caused uropathy were reported to increase annually. In 30% of all septic patients who were diagnosed with urosepsis, 1.5% of them were found in urology and a quarter due to hospital-acquired urinary tract infections (HAUTIs). This study aims to determine the clinical pattern and the frequency of commonly used antibiotics against bacteria associated with urosepsis among Sudanese patients. Methods: This was a cross sectional laboratory-based study, study subjects were recruited from patients attended to Gezira Hospital for Renal diseases and surgery (GHRDS) and was diagnosed, on clinical and laboratory basis, to have urosepsis. Hundred (n = 100) urine samples were collected and inoculated on cysteine lactose electrolyte deficient agar (CLED) media and identify using the suitable biochemical test and performed antimicrobial susceptibility testing (AST) by Kirby Bauer disc diffusion technique for selected antimicrobial agents, according to clinical laboratory standard institute (CLSI) guidelines. Results: Amongst urosepsis infection the frequency of E. coli , S. aureus , Proteus mirabilis , Klebseilla pneumonia and Pseudomonas aeruginosa were (37%, 21%, 10%, 6%, 4% respectively). Resistance to commonly prescribed antibiotics was high, ranging from 17% for meropenem to 100% for cefepime. P. aeruginosa was multidrug resistant compared with other isolates. Conclusions: There was high rate of antibiotic resistance against the common causes of urosepsis in GHRDS, and this reflects the importance of culture and sensitivity test and necessitates adoption of guidelines for selection of suitable antibiotic.