A cross-sectional study was conducted as part of routine surveillance at an outpatient HIV-clinic in Kampala, Uganda. In total, 200 patients aged 18 years and above showing symptoms suggestive of UTI were included in the study. Midstream urine samples were analyzed, and urine cultures were subjected to antibiotic sensitivity testing.

Out of the 200 patients, 123 (62%) were female.  The median age was 40.1 years for females and 43.9 years for males. Only 32 (16%) showed bacterial growth. Escherichia coli was the most commonly isolated uropathogen (72%), followed by Klebsiella pneumoniae (9%). The sensitivity of E. coli towards ampicillin and cotrimoxazole was 0%; towards ciprofloxacin and ceftriaxone was at 56% and 65% respectively; towards nitrofurantoin, gentamicin and imipenem was 100%.

Most isolated uropathogens showed complete resistance to ampicillin and cotrimoxazole, as well as low sensitivity to ciprofloxacin and ceftriaxone. Sensitivity was high towards nitrofurantoin, imipenem and gentamicin. These findings concur with the Uganda treatment guidelines which recommend nitrofurantoin as the drug of choice for the treatment of uncomplicated UTIs. It is noteworthy that the majority of cultures showed no bacterial growth. This is a concern and further studies are needed to address the reasons behind the low rate of bacterial growth on urine culture.

We would like to thank University of Zurich- based doctoral student, Maurice Koller, for his work on this project.