{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:58:38Z","timestamp":1792425518814,"version":"4.5.0"},"reference-count":36,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T00:00:00Z","timestamp":1650067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In sub-Saharan Africa, there is limited information about the use of microbiology laboratory services in patients with suspected urinary tract infections (UTIs). This cross-sectional study assessed the requests for urine culture in patients with suspected UTI in two tertiary (maternal and paediatric) hospitals\u2014Freetown and Sierra Leone, during May 2017\u2013May 2021\u2014and determined antimicrobial resistance (AMR) patterns among bacterial isolates. One laboratory served the two hospitals, with its electronic database used to extract information. Overall, there were 980 patients, of whom 168 (17%) had cultures requested and performed. Of these, 75 (45%) were culture positive. During 2017\u20132019, there were 930 patients, of whom 156 (17%) had cultures performed. During 2020\u20132021, when services were disrupted by the COVID-19 pandemic, there were 50 patients, of whom 12 (24%) had cultures performed. The four commonest isolates were Escherichia coli (36), Klebsiella pneumoniae (10), Staphylococcus aureus (9), and Pseudomonas spp. (6). There were high levels of AMR, especially for trimethoprim-sulfamethoxazole (47%), nalidixic acid (44%), nitrofurantoin (32%) and cefotaxime (36%). Overall, 41 (55%) bacterial isolates showed multidrug resistance, especially E. coli (58%), Pseudomonas spp. (50%), and S. aureus (44%). These findings support the need for better utilization of clinical microbiology services to guide antibiotic stewardship and monitoring of trends in resistance patterns.<\/jats:p>","DOI":"10.3390\/ijerph19084865","type":"journal-article","created":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T04:21:28Z","timestamp":1650255688000},"page":"4865","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Culture Requests and Multi-Drug Resistance among Suspected Urinary Tract Infections in Two Tertiary Hospitals in Freetown, Sierra Leone (2017\u201321): A Cross-Sectional Study"],"prefix":"10.3390","volume":"19","author":[{"given":"Julian S. O.","family":"Campbell","sequence":"first","affiliation":[{"name":"Ola During Children\u2019s Hospital (ODCH) and Princess Christian Maternity Hospital (PCMH) Laboratory, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6627-0474","authenticated-orcid":false,"given":"Saskia","family":"van Henten","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4512-8038","authenticated-orcid":false,"given":"Zikan","family":"Koroma","sequence":"additional","affiliation":[{"name":"Directorate of Laboratory, Diagnostics and Blood Services, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1454-4650","authenticated-orcid":false,"given":"Ibrahim Franklyn","family":"Kamara","sequence":"additional","affiliation":[{"name":"Infection Prevention and Control Unit-Health Security and Emergency Cluster, World Health Organization Country Office, Freetown 00232, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gladys N.","family":"Kamara","sequence":"additional","affiliation":[{"name":"Joint Medical Unit, Ministry of Defense, Republic of Sierra Leone Armed Forces, Freetown 00232, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8242-1911","authenticated-orcid":false,"given":"Hemant Deepak","family":"Shewade","sequence":"additional","affiliation":[{"name":"Division of Health System Research, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai 600077, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6113-9741","authenticated-orcid":false,"given":"Anthony D.","family":"Harries","sequence":"additional","affiliation":[{"name":"Centre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), 2 Rue Jean Lantier, 75001 Paris, France"},{"name":"Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S0140-6736(15)00474-2","article-title":"Access to effective antimicrobials: A worldwide challenge","volume":"387","author":"Laxminarayan","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e18082","DOI":"10.7554\/eLife.18082","article-title":"Epidemiology and burden of multidrug-resistant bacterial infection in a developing country","volume":"5","author":"Lim","year":"2016","journal-title":"eLife"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1086\/318850","article-title":"Urinary tract infections: Disease panorama and challenges","volume":"183","author":"Stamm","year":"2001","journal-title":"J. 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