NIMR raises alarm over UTI infections

TANGA: THE National Institute for Medical Research (NIMR) study has sounded an alarm on superbug Urinary Tract Infections (UTIs).

According to the statement released by NIMR, the study conducted at hospitals in Tanga and Korogwe analysed over 2,000 urine samples and revealed concerning levels of antimicrobial resistance (AMR) among common uropathogens in the studied region.

In the statement, Laboratory Technologist Mr Edward Msoma, based at NIMR Tanga Centre, said the main causative pathogen detected included Escherichia coli, the primary culprit, which showed 77 per cent AMR to ciprofloxacin and 100 per cent resistance to ampicillin.

He said the two antibiotics are commonly prescribed for UTIs in Tanzania. NIMR’s Co-investigator in the study, Mr Athanas Mhina, said this is not just about superbugs but a major challenge in diagnostic approaches to UTIs.

“Our data suggests a cycle of overdiagnosis. Patients with non-specific symptoms are given a dipstick test, which is often misinterpreted as a definitive UTI. The issue has led to antibiotic prescriptions for infections that may not be the case. Each unnecessary antibiotic prescription increases drug selection pressure and leads to bacteria surviving, making simple UTIs untreatable with common antibiotics,” Mr Mhina said.

ALSO READ: ILO, CHODAWU empower domestic workers in Mwanza

The study highlighted a critical gap between clinical practice and accurate diagnosis that may be the case in many facilities across the country.

According to NIMR, a positive dipstick test may indicate other issues such as inflammation and not necessarily a confirmed bacterial infection.

“Other conditions such as vaginal infections or non-bacterial inflammation can trigger a false positive. Treatment of these patients with antibiotics is ineffective and risks the selection of antibiotic-resistant strains,” read the statement.

Mr Mhina said the 18.6 per cent bacterial culture positivity rate in their study implies that the majority of suspected UTI cases sent to the lab did not grow significant bacteria.

“This is strong evidence that we are treating far too many people who do not have bacterial UTIs and subsequently fuelling AMR. It also underscores a critical need to assess our diagnostic capacity at our facilities, specifically based on culture-based and sensitivity testing, to be strengthened to meet patient clinical needs,” he said.

Amid these alarming findings, however, the study identifies a silver lining through a clear and actionable path forward in UTI management.

NIMR noted that sensitivity testing revealed a highly effective first-line antibiotic drug, nitrofurantoin. The study demonstrated that this oral antibiotic retains a high 94.3 per cent susceptibility rate, making it a potent, affordable and accessible treatment.

The researchers suggest that the drug should be prioritised and protected as the first-choice treatment for laboratory-confirmed, uncomplicated UTIs to safeguard its long-term efficacy and use.

Commenting on the study results, NIMR Director General Professor Said Aboud underscored the link between accurate laboratory diagnosis and effective treatment. “Our approach must evolve from presumptive to confirmed laboratory diagnosis.

‘Test before you prescribe’ is not just a slogan; it is a critical clinical practice to reduce unnecessary antibiotic pressure and combat the AMR problem. This issue, however, requires intentional and sustained investment in diagnostic laboratory capacity nationwide,” he stated.

Professor Aboud further emphasised that the fight against AMR will be realised through strong investment in the laboratory system to ensure accessibility and affordability of quality diagnostics and prescription practices.

“This fight is won or lost at the laboratory bench. We require investment first in laboratory infrastructure and in the competence of our personnel to perform culture and drug susceptibility testing,” he said.