Antibiotic-resistant Escherichia coli and Associated Risk Factors in Dialysis Patients with Urinary Tract Infections in the Bamenda Health District: A Comparative Analysis with Non-dialytic Participants

Background: Urinary tract infections are a public health problem affecting all individuals. However, its impact on patients with kidney failure needs to be determined. The main aim of this research was to investigate the prevalence and antibiotic-resistant pattern of Escherichia coli causing urinary tract infection in patients on dialysis and non-dialyzing participants in the Bamenda Health District. Methods: This was a cross-sectional study conducted from January to June 2024, and involved collection of urine samples from dialytic (45) and non-dialytic (59) participants. The urine samples were cultured on Cysteine-Lactose-Electrolyte-Deficient agar and MacConkey agar. Positive cultures typical of E. coli were identified using API20E. Antibiotic susceptibility testing was done using Kirby-Bauer Disc diffusion method. The data was analysed using the Statistical Package for Social Sciences software. Results: The age of the participants ranged from 17 to 78 years with a mean (std) age of 37.95(10.86) years. The prevalence of E. coli was 25% (26/104) and was insignificantly (p = 0.732) higher in patients on dialysis (26.7%) than in non-dialyzing participants (23.7%). All isolates were resistant to two or more antibiotics. Drug resistance was highest with ofloxacin (83.3%) and ciprofloxacin (77.8%) in dialysis patients while nitrofurantoin was the most active drug (19; 73.08%). Multidrug resistance was recorded in 18 (69.2%) of the isolates and was significantly higher (p=0.011) in patients on dialysis 12(92.3%). The age groups of less than 30 years (AOR; 0.042, p=0.000] and 30-40 years (AOR; 0.120, p=0.01) and being on dialysis (AOR 5.488, p=0.017) were identified as risk factors for antibiotic resistance. Conclusion: This study showed that the prevalence of drug resistance is high and there is need for policy makers to establish policies for the prudent use of antibiotics in dialysis units.