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Community Antibiotic Use, Susceptibility and ResisTance Among Patients With Urinary Tract Infections (CAST-UTI)

Recruiting
Conditions
Urinary Tract Infections (UTIs)
Registration Number
NCT07012421
Lead Sponsor
St George's, University of London
Brief Summary

1. General objective

This pilot study aims to compare the prevalence of resistance in bacteria causing UTIs among patients seeking care outside the hospital settings (CDROs) to the WHO-GLASS data.

2. Specific objectives

2-1 Primary objectives:

* Determine the resistance profiles of uropathogens and carriage strains from patients with uncomplicated UTIs attending community drug retail outlets (CDRO's) and in hospitals\*.

* Compare the resistance profiles of the uropathogens from patients with uncomplicated UTIs attending CDROs and hospitals to those in the WHO-GLASS database.

* Explore the patient pathway and its impact on antibiotic use among patients presenting to CDROs and hospitals with uncomplicated UTIs.

* Determine the appropriateness of antimicrobial use in the treatment of uncomplicated UTIs among patients presenting to CDROs and hospitals

2-2 Secondary objectives:

* Compare resistance profiles among the uropathogens from patients from two neighbourhoods in Kampala.

* Examine environmental samples between the study sites to determine the presence of antibiotic residues and AMR two neighbourhoods in Kampala.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
3000
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
A comparison of resistance profiles between GLASS and community uropathogens in UgandaAt the end of 12 months data collection

Twelve-month prevalence of antimicrobial resistance in Escherichia coli and Klebsiella pneumoniae isolates causing urinary tract infections, comparing GLASS surveillance data and data collected in the community in Uganda. Resistance will be measured as the proportion of isolates non-susceptible to key antibiotic classes (e.g., third-generation cephalosporins, fluoroquinolones, carbapenems).

Secondary Outcome Measures
NameTimeMethod
Patient pathway and antibiotic use in the community28 days

Characterisation of the patient pathway from symptom onset to days 7 and 28 in individuals with urinary tract infections, and its association with antibiotic use patterns (e.g., timing, type, source, appropriateness).

Collect information on healthcare seeking behaviour for eligible patients, including their sociodemographic information, antibiotics purchased, and cost of antibiotics.

Appropriateness of antimicrobial use in the treatment7 days after enrolment

Proportion of UTI cases in the community with microbiologically confirmed E. coli or K. pneumoniae where the prescribed or obtained antibiotic treatment was appropriate, based on standard treatment guidelines and the organism's resistance profile.

Retail outlet determinants of treating healthcare-seeking among patients with suspected UTIsAt the end of 12 months after enrolment

The investigators are collecting information on the number of UTIs presenting at community drug retail outlets over twelve months, antibiotic availability in the ommunity drug retail outlet, compliance with regulations, and healthcare worker training level.

Antibiotic residues and AMR in two neighbourhoods in KampalaOnce a month for 12 months after study commencement

Detection of antibiotic residues and antimicrobial resistant organisms in environmental water samples from channels linking the two study neighbourhoods.

Through detection of antibiotic residues and testing of microorganisms isolated from the waterway and sediment.

Trial Locations

Locations (1)

Infectious Diseases Research Collaboration (IDRC), Uganda

🇺🇬

Kampala, Central Region, Uganda

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