title: Urinary tract infection among fistula patients admitted at Hamlin fistula hospital, Addis Ababa, Ethiopia.
abstract: Urinary Tract Infection (UTI) causes a serious health problem and affects millions of people worldwide. Patients with obstetric fistula usually suffer from incontinence of urine and stool, which can predispose them to frequent infections of the urinary tract. Therefore the aim of this study was to determine the etiologic agents, drug resistance pattern of the isolates and associated risk factor for urinary tract infection among fistula patients in Addis Ababa fistula hospital, Ethiopia.
  
  
  
  Across sectional study was conducted from February to May 2015 at Hamlin Fistula Hospital, Addis Ababa, Ethiopia. Socio-demographic characteristics and other UTI related risk factors were collected from study participants using structured questionnaires. The mid-stream urine was collected and cultured on Cysteine lactose electrolyte deficient agar and blood agar. Antimicrobial susceptibility was done by using disc diffusion method and interpreted according to Clinical and Laboratory Standards Institute (CLSI). Data was entered and analyzed by using SPSS version 20.
  
  
  
  Out of 210 fistula patients investigated 169(80.5%) of the patient were younger than 25 years. Significant bacteriuria was observed in 122/210(58.1%) and 68(55.7%) of the isolates were from symptomatic cases. E.coli 65(53.7%) were the most common bacterial pathogen isolated followed by Proteus spp. 31(25.4%). Statistical Significant difference was observed with history of previous UTI (P = 0.031) and history of catheterization (P = 0.001). Gram negative bacteria isolates showed high level of resistance (>50%) to gentamicin and ciprofloxacin, while all gram positive bacteria isolated were showed low level of resistance (20-40%) to most of antibiotic tested.
  
  
  
  The overall prevalence of urinary tract infection among fistula patient is 58.1%. This study showed that the predominant pathogen of UTI were E.coli followed by Proteus spp. It also showed that amoxicillin-clavulanic acid was a drug of choice for urinary tract bacterial pathogens.
authors.affiliation: Department of medicine, Collages of medicine and health sciences, Ambo University, Ambo, Ethiopia. matiy2016@yahoo.com.
authors.forename: Matifan
authors.initials: M
authors.lastname: Dereje
authors.affiliation: Department of Microbiology, Immunology & Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Yimtubezinesh
authors.initials: Y
authors.lastname: Woldeamanuel
authors.affiliation: Department of Microbiology, Immunology & Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Daneil
authors.initials: D
authors.lastname: Asrat
authors.affiliation: Addis Ababa Hamlin Fistula Hospital, Addis Ababa, Ethiopia.
authors.forename: Fekade
authors.initials: F
authors.lastname: Ayenachew
mesh_terms: D000293:Adolescent; D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001437:Bacteriuria / Q000453:epidemiology; D002648:Child; D005002:Ethiopia / Q000453:epidemiology; D005242:Fecal Incontinence / Q000150:complications*; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D011247:Pregnancy; D015995:Prevalence; D012006:Rectovaginal Fistula / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D014549:Urinary Incontinence / Q000150:complications*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination
keywords: Addis Ababa; Ethiopia; Fistula patients; Hamlin Fistula Hospital; UTI