BACTERIAL PROFILE IN STERILE BODY FLUIDS, ASSOCIATED FACTORS, AND ANTIBIOTIC SUSCEPTIBILITY PATTERNS AMONG PATIENTS AT HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL, HARAR, EASTERN ETHIOPIA

Abstract

Sterile body fluids, such as cerebrospinal, pleural, peritoneal, pericardial, and synovial fluid, are all susceptible for serious invasive bacterial infections and critical, with high morbidity and sequelae risk. The study on bacterial profiles, associated factors, and their drug susceptibility patterns from sterile body fluids has not been conducted previously in eastern Ethiopia. Objective: The present study was designed to determine the bacterial profile, associated factors, and their susceptibility to antimicrobial agents among patients with sterile body fluids at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia, from April 1 to June 20, 2021. Methods: Hospital-based cross-sectional study was conducted among 204 patients selected by convenient sampling technique. Data were collected using a structured questionnaire and laboratory tests. Any consenting patients submitting sterile body fluid specimens for testing at clinical laboratory were included and analyzed using conventional culture methods and biochemical tests. Antimicrobial susceptibility testing was determined using the disk diffusion method and interpreted as per Clinical and Laboratory Standards Institute guidelines. Data were double entered into Epi data version 4.6 exported and analyzed using Statistical Package for Social Science version 25. Bivariate and multivariable logistic regressions analysis were used to assess the association between outcome and predictor variables. P-value<0.05 was considered as statistically significant. Results: The overall prevalence of bacteria among different sterile body fluid samples was 16.7% (95% CI: 12%-22%). Majority of the bacterial isolates (70.6%) were Gram-negative bacteria. The commonest isolates were K. pneumoniae (26.5%) and E. coli (20.6%). 76.5% were Multidrug resistant, mainly against beta-lactams. Being admitted patient (AOR=3.59; 95% CI: 1.52, 8.21) and turbid appearance of the specimen (AOR=4.35; 95% CI: 1.67, 11.29) were significantly associated with culture positivity rate. Conclusion: The prevalence of bacterial isolates in this study comprises about 17%. Gram negative bacteria particularly, K. pneumoniae and E. coli were the major etiologic agents. Being admitted patient and the turbid appearance of the specimen was significantly associated with culture-positive rates. Most of the isolates were resistant to penicillin and 3 rd -generation cephalosporin and significant numbers of multidrug-resistant bacteria were isolated. Therefore, culture and susceptibility testing with continuous surveillance should be an integral part of the laboratory investigation for better outcome for the patient