Abou Kebbeh

Background: Antimicrobial resistance poses a public health threat for the treatment of community-acquired urinary tract infections. This study determined the susceptibility patterns of uropathogens and associated risk factors among outpatients diagnosed with urinary tract infections at the Kanifing General Hospital in the Gambia. Methods: A cross-sectional analytic study was conducted among patients with suspected urinary tract infections at Kanifing General Hospital from March to May 2021. Data on socio-demographic and other risk factors were collected from the study participants using a structured pre-tested questionnaire. Mid-stream urine samples were collected, and bacteria identification and antimicrobial susceptibility testing done using standard microbiological methods. Descriptive and inferential statistical analysis were done to determine factors associated with urinary tract infection at 95% confidence level and a p -value < 0.05. Results: A total of 422 patients were enrolled with 82.5% (348/422) being females. The prevalence of community acquired urinary tract infection was 12.8% (54/422). Escherichia coli was the most prevalent isolate (74.1%, 40/54), followed by Klebsiella spp (8.5%, 10/54). Antimicrobial resistance was highest for Ampicillin (87.0%, 47/54), Trimethoprim/Sulfamethoxazole (77.8%, 42/54) and Tetracycline (75.9%, 41/54). Uropathogens sensitivity was 77.8% (42/54) for Nitrofurantoin and 75.9% (41/54) for Ceftazidime. Being female (aOR 5.90 95% CI = 1.48–23.67), previous history of urinary tract infection (aOR 2.34, 95% CI = 1.06–5.14), use of unprescribed antibiotics (aOR 2.0, 95% CI = 1.05–3.62) and having no formal education (aOR 8.02, 95% CI = 1.04–62.0) were significant factors associated for having uropathogenic bacterial infection. Conclusion: E. coli was the most prevalent uropathogen isolated. Ciprofloxacin, Nitrofurantoin and Ceftazidime were the most sensitive antibiotics. Routine surveillance of susceptibility of uropathogenic bacteria would be helpful to update clinicians on the choice of antibiotics.

Background: Salmonella spp are among the most common food borne pathogens. Food handlers play an important role in the production of food products, in which they can contribute to the transmission of salmonellosis. The probability of food contamination depends mainly on the health status and personal hygiene of the food handlers and their choice of managing their health could give rise to contamination of food by multi drug resistant bacteria. Multi Drug Resistance is of global concern and poses a public health threat in combating diseases. In the developing countries there is paucity on the prevalence of salmonella carriage among food handlers. This study aims to investigate the prevalence of salmonella and to determine their antimicrobial resistance pattern. Method: A total of 500 stool samples from different food handlers were collected and analyzed with completed questionnaires. For standard isolation and identification of salmonella isolates; stool samples were enriched in buffered peptone water, standard culture and biochemical tests were used. Antimicrobial susceptibility Test (AST) was carried out using Clinical Laboratory and Standard Institute (CLSI-2015) protocol disc diffusion method. The data were analyzed using SPSS version 16 and Microsoft excel version 2010 to determine the risk factors. Results: Of 500 participants with the mean age of 38.15, 497(99.4%) were all females. Most of the participants wash their hands under running water and 271(54.2%) were certified on food handling. Among the risk factors, consuming medicines/antibiotics from street vendors showed statistical significant of salmonella carriage with (P=0.011). It was found that 13(2.6%) were salmonella carriers. AST performed on the 13 isolates show that; 13(100%), 12(92.3%), 7(53.8%), 9(69.2%) and 9(69.2%) were resistant to Ampicillin, Erythromycin, and Tetracycline, ceftriaxone and cefotaxime respectively. And 13(100%), 12(92.3%) and 7(53.8) were sensitive to Imipenem, chloramphenicol and gentamycin respectively. Conclusion: This study had found multidrug resistant salmonella isolates carriers amongst food handlers who could serve as potential reservoirs for the transmission of these infections in the communities. Thus, it is crucial to implement regular screening of food handlers and health education on food safety.