BACKGROUND Urinary tract infections (UTIs) are among the most common infections in the community and hospital settings and Enterobacteriaceae, are responsible for most infections. This study determined the prevalence and resistance trends of E. coli and K. pneumoniae to fluroquinolones and cephalosporins among out-patients diagnosed with urinary infections at a Zonal tertiary hospital in Tanzania

METHODS This was a prospective cross sectional time series conducted in northern Tanzania and enrolled all out patients presenting with UTI symptoms. The study conducted for a period of six months between march 2021 to September 2021.

RESULTS During the study period1582 patients were enrolled, the mean age was 20.2(SD 22.2) years and 883(55.8%) were female. The prevalence of E. coli was higher in female patients at 12.0% compared 6.7% in male. Both E. coli and K. pneumoniae were most prevalent in patients over >45 years at 13.3% and 3.2% respectively. E.coli resistance to Ceftriaxone, cefepime, and ciprofloxacin was 41.0%, 36.8% and 51.0% respectively. Resistance K. pneumoniae to ceftriaxone, cefepime, and ciprofloxacin was shown to be 52.8%, 47.4% and 28.2% respectively. Meanwhile, 76/192(39.6%) isolates were identified as ESBL.

CONCLUSIONS In this setting empirical treatment of urinary tract infections with ciprofloxacin a commonly prescribed antibiotics for this diagnosis may not work in over half of patients when E,coli is the causative pathogen. Moreover, E. coli, resistance of 43% to ceftriaxone implies that patients who do not respond to initial therapy with ciprofloxacin, are at a risk of not responding to subsequent therapy necessitating the use of reserve antibiotics.

The authors have declared no competing interest.

This work was supported by the Department of Health and Social Care's Fleming Fund using UK aid. The views expressed in this publication are those of the authors and not necessarily those of the UK DHSC or its management Agent.

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Ethical clearance for the study was issued by the National Institute for Medical Research- Reference code (NIMR/HQ/R.8a/Vol.IX/3554

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The data is available via reasonable requests directed to the Tanzania Fleming Fund Fellowship consortium.