Carbapenem resistance among uropathogens isolated from Refugees at Nakivale settlement Isingiro district-a cross sectional study

Abstract Introduction: Carbapenem resistant Uropathogens are an ongoing public-health problem globally. This is mediated by transferable Carbapenemase-encoding genes spreading rapidly causing serious outbreaks and dramatically limiting treatment options. Knowledge about the prevalence and factors associated with carbapenem resistant Uropathogens and common carbapenem resistance genes among refugees in Nakivale is limited. Methods. We recruited 308 consenting participants in Nakivale refugee settlement in south western Uganda. Quantitative conventional culture on Cysteine Lactose Electrolyte Deficiency (CLED) agar and conventional biochemical tests were used for isolation. The Modified Hodges test was used for phenotypic screening of Carbapenem resistant producing isolates and interpretation made using the Clinical Laboratory Standard Institute guidelines, 2022. DNA was extracted by boiling method and Carbapenemase genes assayed by Gel Electrophoresis. Bivariate and multivariate logistic regression using STATA version14.0 was done to identify the factors associated with Carbapenem resistance producers. Ethical clearance was obtained from MUST-Institutional Review board. Results. The overall significant single bacterial growth was 28.8% (89/308). The Phenotypic and genotypic prevalence of Carbapenem resistance was 61.8% (55/89) and 22.5% (20/89) respectively. The commonest isolate was Escherichia coli, 35.5% (32/89) while the most frequent carbapenemase resistant gene was KPC,15% (13/89). Factors associated with Carbapenem resistance were; history of self-medication (OR = 5.09, 95% CI: 1.04–24.77, p < 0.044), antibiotic use before laboratory diagnosis (OR = 6.07, 95% CI: 1.77–20.81, p = 0.004), Having spent more than 5 months on antibiotics (OR = 8.52, 95% CI: 1.47–49.36, p = 0.017). Conclusion . The prevalence of Carbapenem resistance among Uropathogens isolated from refugees at Nakivale settlement was high. Accurate antimicrobial stewardship program implementation in refugee settlements are urgently needed. Screening and identification of Carbapenem Resistant Enterobacterial careers among refugees at entry point could be helpful in mitigating spread in refugee settlement.