Urogenital Infections Among Women Attending Mwingi Hospital, Kitui County, Kenya: Safeguarding Antibiotics Through Microbiological Diagnosis

Abstract

ABSTRACT
Background: Urogenital infections pose a considerable public health threat, as almost half of women will experience urinary and reproductive system infections at some point in their lives. However, the urogenital infection burden is often not clear in some regions. Nevertheless, the misuse of antimicrobial agents, including self-prescription, has increased widespread antimicrobial resistance, limiting treatment benefits. Therefore, this study aimed to identify the various urogenital infections, associated risk factors, and profile the bacterial isolates, and assess their antibiotic resistance among women attending Mwingi Hospital.
Methods: A cross-sectional study was conducted on 322 women aged between the ages of 15 to 44 years. Urine and high vaginal swabs were collected from all participants and analyzed within 6 hours. Microscopic examination on wet mounts was done, bacterial isolation was done and those with significant growth were confirmed and subjected to antimicrobial susceptibility testing using specific media. Descriptive statistics were used in expressing the infection frequencies and antimicrobial resistance. Odds ratios were used to determine the risk of urogenital infection. The level of significance was considered at a P value of less than 0.05.
Results: Among the 322 women, 45.3% (146) had a urogenital infection, with bacteria being the primary cause (26.4%). The infections included UTI (22.7%), Candidiasis (15.2%), Trichomoniasis (3.7%), Gonorrhea (2.5%), and Bacterial vaginitis (1.2%). Antibiotic use was 32.9%, with only 2.8% receiving a microbiological diagnosis before antibiotic use. The overall antibiotic resistance was 53%, with the lowest resistance observed against penicillin and combinations (31.4%) and 3rd Cephalosporins (39.4%). The highest resistance was observed against nalidixic acid (74.8%) and cotrimoxazole (62.6%).
Conclusion: Women attending Mwingi Hospital are commonly affected by various urogenital infections. Antibiotic use without microbiological diagnosis was observed. Among the antibiotics tested, 3rd generation cephalosporins and penicillin combination agents were noted as the most effective in treating bacterial urogenital infections, while nalidixic acid and cotrimoxazole were ineffective. Improved diagnosis and targeted treatments are necessary to prevent further development of antibiotic resistance.