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Study Overview
- Design: Retrospective cross-sectional study.
- Location: Zomba Central Hospital, Malawi.
- Period: January 2020 – December 2021.
- Sample Size: 340 female patient records with confirmed UTIs.
Key Finding
1. Prevalence
- UTI Prevalence: 48.53% among the reviewed records.
- Most Affected Age Group: 15–45 years (53.33%), the reproductive age group.
2. Causative Agents
- Most Common Pathogens:
- Escherichia coli – 27.2%
- Staphylococcus spp. – 26.5%
- Enterobacter spp. – 19.2%
- Citrobacter freundii – 11.9%
- Others: Proteus, Enterococcus, Serratia marcescens, and rare isolates like Klebsiella pneumoniae and Pseudomonas aeruginosa.
3. Antibiotic Resistance
- High Resistance Rates:
- Ampicillin – 87%
- Ceftriaxone – 77%
- Gentamicin – 77%
- Ciprofloxacin – 70%
- Cefoxitin – 64%
- Moderate Sensitivity:
- Meropenem – 51%
- Amikacin – 56%
- Serratia marcescens showed extreme resistance, raising concern about multidrug resistance (MDR).
4. Resistance by Age Group
- Highest resistance in 15–45 age group (51.14%)
- Lower resistance in ≥46 (42.37%) and ≤14 (6.49%) age groups
Conclusions
- UTIs are prevalent among females at Zomba Central Hospital, especially in reproductive-age women.
- High levels of antimicrobial resistance—particularly to first-line antibiotics—pose a serious treatment challenge.
- Implications: The study emphasizes the need for:
- Routine antimicrobial resistance (AMR) surveillance
- Empirical treatment guided by local susceptibility patterns
- Strengthened antibiotic stewardship programs
Strengths
- Provides critical local data in a context (Malawi) where AMR information is limited.
- Highlights patterns in age-specific prevalence and resistance, informing targeted interventions.
Limitations (as alluded to at the end of the text):
- Relies on retrospective data, potentially subject to documentation bias.
- Limited generalizability beyond the study hospital.
- No molecular confirmation of resistance mechanisms (e.g., ESBL genes).
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