Antibiotic Resistance and Resistant Genes among Isolates from Diabetic Patients with Urinary Tract Infections at Benjamin Mkapa Hospital: A Cross-Sectional Study

The emergence of antibiotic-resistant bacteria is a growing public health concern that complicates the prevention, control, and management of bacterial infections and has become a global challenge. Urinary tract infections (UTIs), which are among the most common bacterial infections worldwide, are increasingly associated with antibiotic-resistant pathogens. The present study focused on determining both the phenotypic and genotypic characteristics of antimicrobial-resistant bacteria isolated from diabetic patients with UTIs at Benjamin Mkapa Hospital in the Dodoma region, Tanzania.

This hospital-based cross-sectional study was conducted at Benjamin Mkapa Hospital (BMH) in Dodoma, Tanzania. Midstream urine samples were collected and inoculated onto blood agar and Cystine–Lactose–Electrolyte-Deficient (CLED) agar. Antibiotic susceptibility testing (AST) was performed using the Kirby–Bauer disc diffusion method, and results were interpreted according to the 2024 Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were expressed as percentages and proportions. Sequencing results were analysed using the BLAST online search tool.

Out of 419 cultured samples, 261 (62.3%) showed significant bacterial growth. The isolates included coagulase-negative staphylococci (CoNS), Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus. The majority of the isolates were susceptible to amikacin (97%), piperacillin–tazobactam (72%), imipenem (78%), and meropenem (89%). The following genes were detected among the isolates: blaCTX-M-15, blaOXA-1, blaNDM-5, blaTEM-1B, aac(3)-IId, qnrS1, aacA-aphD, blaSHV, and blaTEM.

This study investigated antimicrobial resistance patterns and associated resistance genes among uropathogens isolated from diabetic patients with UTIs at Benjamin Mkapa Hospital, Dodoma. Out of 419 samples, 261 (62%) yielded bacterial isolates, with Escherichia coli being the most prevalent. All isolates were multidrug-resistant, showing high resistance to commonly used antibiotics such as ceftazidime, amoxicillin/clavulanic acid, ciprofloxacin, and ampicillin, but retained susceptibility to meropenem, amikacin, and imipenem. Molecular analysis revealed the presence of key resistance genes, including blaNDM-5, blaCTX-M-15, and qnrS1. These results indicate a high burden of antimicrobial resistance among diabetic patients with UTIs and emphasize the importance of integrating molecular diagnostics into routine laboratory practice.

Screening for antibiotic resistance genes in parallel with antibiotic susceptibility testing is important for the control and management of resistant isolates.