Culture Requests and Multi-Drug Resistance among Suspected Urinary Tract Infections in Two Tertiary Hospitals in Freetown, Sierra Leone (2017–21): A Cross-Sectional Study

Julian S. O. Campbell, Saskia van Henten, Zikan Koroma, Ibrahim Franklyn Kamara, Gladys N. Kamara, Hemant Deepak Shewade and Anthony D. Harries
Additional contact information
Julian S. O. Campbell: Ola During Children’s Hospital (ODCH) and Princess Christian Maternity Hospital (PCMH) Laboratory, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone
Saskia van Henten: Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
Zikan Koroma: Directorate of Laboratory, Diagnostics and Blood Services, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone
Ibrahim Franklyn Kamara: Infection Prevention and Control Unit-Health Security and Emergency Cluster, World Health Organization Country Office, Freetown 00232, Sierra Leone
Gladys N. Kamara: Joint Medical Unit, Ministry of Defense, Republic of Sierra Leone Armed Forces, Freetown 00232, Sierra Leone
Hemant Deepak Shewade: Division of Health System Research, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai 600077, India
Anthony D. Harries: Centre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), 2 Rue Jean Lantier, 75001 Paris, France

IJERPH, 2022, vol. 19, issue 8, 1-12

Abstract: In sub-Saharan Africa, there is limited information about the use of microbiology laboratory services in patients with suspected urinary tract infections (UTIs). This cross-sectional study assessed the requests for urine culture in patients with suspected UTI in two tertiary (maternal and paediatric) hospitals—Freetown and Sierra Leone, during May 2017–May 2021—and determined antimicrobial resistance (AMR) patterns among bacterial isolates. One laboratory served the two hospitals, with its electronic database used to extract information. Overall, there were 980 patients, of whom 168 (17%) had cultures requested and performed. Of these, 75 (45%) were culture positive. During 2017–2019, there were 930 patients, of whom 156 (17%) had cultures performed. During 2020–2021, when services were disrupted by the COVID-19 pandemic, there were 50 patients, of whom 12 (24%) had cultures performed. The four commonest isolates were Escherichia coli (36), Klebsiella pneumoniae (10), Staphylococcus aureus (9), and Pseudomonas spp. (6). There were high levels of AMR, especially for trimethoprim-sulfamethoxazole (47%), nalidixic acid (44%), nitrofurantoin (32%) and cefotaxime (36%). Overall, 41 (55%) bacterial isolates showed multidrug resistance, especially E. coli (58%), Pseudomonas spp. (50%), and S. aureus (44%). These findings support the need for better utilization of clinical microbiology services to guide antibiotic stewardship and monitoring of trends in resistance patterns.

Keywords: uropathogens; culture requests; antibiotic sensitivity testing; secondary data; children; pregnant women; West Africa; SORT IT; operational research; Sierra Leone (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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