Frequency of Antimicrobial Resistant Bacteria Isolated from Circumcised Women Suffering from Urinary Tract Infections in Different Clinics in Khartoum locality

Abstract

Urinary tract infections (UTIs) are one of the diseases that are widely spreading among women, due to several factors. The most important of which is the different nature of the composition of the urinary system, which is characterized by the shortage the urinary and its proximity to the anus in addition to the change caused by circumcision that leads to the narrowness of the opening of the urinary system and vigilantes on the other. This cross-sectional study was conducted from April 2019 to February 2021 to detect the frequency of antimicrobial resistance bacteria isolated from circumcised women attending Dan Medical Complex and Nobatia Medical Clinic. Isolation, identification and antimicrobial susceptibility testing were done by conventional methods. Eighty (n = 80) mid-stream urine specimens were collected from all eligible volunteers, in which 40 were circumcised and other 40 were not, their ages ranged from 7 to 70 years with mean of age 29.3 ± 13.0 S.D. About 16/40 (40 %) of circumcised women were married and 23/40 (60%) were single, while among non-circumcised group there were 7/40 (17.5%) married and 33/40 (82.5%) were single. The growth rate was 34/40 (85%) among circumcised females and 6/40 (15%) among non-circumcised participants and there were significant association (P-value= 0.000) between circumcision and UTIs. Based on the odd ratio (O.R) the risk factor of UTIs was 32 times greater among circumcised females than non-circumcised one. The isolated bacteria were 24/40 (60%) Gram negative rods and 10/40 (15%) were Gram positive cocci among circumcised women while there were only 6/40 (15%) Gram negative rods and no isolated Gram positive among non-circumcised one. There were meaningless association between circumcision and bacteria according to Gram’s stain (P-value=0.125). Among the isolated bacteria; Escherichia coli was the most predominant isolate among circumcised and non-circumcised women (15 (37.5%)). Concerning circumcised women; the isolated bacteria were moderately sensitive to Augmentin (22/34 (67.7%)) and Gentamycin (20/34 (58.8%)) compared to other antimicrobial agents (Ciprofloxacin 16/34 (47.1%), Cefuroxime (12/34 (35.3) and Amoxycillin (10/34 (29.4%)) and all isolated Gram negative rods bacteria were highly resistant to nalidixic acid (100.0%). In contrast to non-circumised women; all the isolated bacteria (G-ve rods) were highly sensitive to Gentamicin (6/6 (100.0%) and cefuroxime (5/6 (83.3%), and moderately sensitive to Augmentin (4/6 (66.7%) and Ciprofloxacin (4/6(66.7%). Also all isolated bacteria were highly resistant to Nalidixic acid and Amoxycillin except K.pnemoniae was higly sensitive (100.0%) for both antimicrobial agents. In conclusion, the frequency of UTIs and antimicrobial resistance were high among circumcised women.