Health facility-based prevalence of typhoid fever, typhus and malaria among individuals suspected of acute febrile illnesses in Southwest Region, Ethiopia.

Background: Acute febrile illnesses such as typhoid fever, typhus, and malaria are still major causes of hospital admission in many parts of Ethiopia. However, there are substantial gaps in the monitoring systems, which result in a lack of knowledge about the geographic distribution and role of common pathogens, particularly in rural areas. Thus, this study was aimed at assessing the seroprevalence of typhoid fever, typhus, and malaria among suspected acute febrile patients at the MTU Teaching Hospital and Mizan-Aman Health Center, Southwest region of Ethiopia. Method: A health facility-based cross-sectional study was carried out from July to October 2022. Blood samples were collected from a total of 384 individuals. Widal and Weilfelix direct card agglutination and tube agglutination test methods were used for the Salmonella enterica serotype Typhi (S. typhi) and Rickettsia infections. The diagnosis of malaria was made using thick and thin blood smears. Questionnaires given by interviewers were used to gather information on risk factors and other sociodemographic factors. The data was analyzed using STATA/SE 14.0. Result: A total of 371 patients were tested for S. Typhi and Rickettsia infections using direct card agglutination and tube agglutination methods. Using the screening test, 20.5% (76/371) patients were reactive either for O or H antigens or both, of which 55.3% (42/76) were reactive by the titration test at the cutoff value ≥ 1:80. About 17.5% (65/371) were reactive to OX19 antigen by card agglutination test, and of which 58.5% (38/65) were reactive by the titration test at the cutoff value ≥ 1:80. The overall seroprevalence of S. Typhi and Rickettsia infections using combined direct card and tube agglutination techniques was 11.3% (42/371) and 10.2% (38/371), respectively. Out of 384 suspected malaria patients, 43 (11.2%) were found positive either for P. falciparum, 27 (7.03%), or P. vivax, 16 (4.2%). Conclusion: In this study, typhoid fever, typhus, and malaria were found among symptomatic acute febrile patients. To increase disease awareness, it is necessary to provide sustainable health education about risk factor behaviors, disease transmission, and prevention strategies. In addition, improving laboratory diagnosis services and early treatment may also lower the likelihood of potentially fatal consequences.

Exploring how stay-at-home orders during the COVID-19 pandemic impedes engagement along the HIV/AIDS care continuum in public hospitals of Southwest Ethiopia: a qualitative study.

Introduction: COVID-19 has rapidly spread across the world. In March 2020, shortly after the first confirmed case of COVID-19 in Ethiopia in March 2020, the government of Ethiopia took several measures. Purpose: This study aims to explore how stay-at-home orders during the COVID-19 pandemic hinder engagement with HIV/AIDS care in public hospitals in Southwest Ethiopia. Additionally, we aim to explore the psychosocial challenges faced in accessing services during stay-at-home orders. Methods: A descriptive qualitative study was conducted from 20 May to 3 June 2020, using semi-structured, in-depth interviews. In total, 27 study participants were recruited from purposively selected people living with HIV/AIDS (PLWHA) who had experienced delays, declines, or discontinuation of care after COVID-19 was confirmed in Ethiopia on 13 March 2020. The participants were interviewed over the phone and their responses were audio-recorded. Data were transcribed verbatim, translated, and analyzed using inductive thematic analysis in the Atlas ti.7.1 software package. Results: The main themes and sub-themes that emerged were psychosocial issues (such as depression, hopelessness, and fear), risk perception (including high risk, susceptibility, and severity), forceful enforcement of stay-at-home orders (such as police beatings, community leaders disgracing, and influence of families and relatives), socioeconomic factors (such as stigma, religion, and transportation costs), misinformation about COVID-19 (such as lockdowns and ART stock-outs), and healthcare factors (such as inadequate health information and long distances to healthcare facilities). Conclusion: Overall, these findings were similar to the challenges experienced by PLWHA in adhering to the recommended continuum of care. However, there are additional factors due to COVID-19, such as misinformation and the forceful implementation of the stay-at-home-orders, that impede the continuum of care. Therefore, it is important to strengthen information, education, and communication.

Drug resistance and extended-spectrum ß-lactamase (ESBLs) - producing Enterobacteriaceae, Acinetobacter and Pseudomonas species from the views of one-health approach in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Although antimicrobial resistance (AMR) bacteria present a significant and ongoing public health challenge, its magnitude remains poorly understood, especially in many parts of the developing countries. Hence, this review was conducted to describe the current pooled prevalence of drug resistance, multidrug- resistance (MDR), and Extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae, Acinetobacter, and Pseudomonas species in humans, the environment, and animals or food of animal origin in Ethiopia. METHODS: PubMed, Google Scholar, and other sources were searched for relevant articles as per the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A critical appraisal for screening, eligibility, and inclusion in the meta-analysis was made based on the Joanna Briggs Institute's (JBI) essential appraisal tools. The meta-analysis was done on Statistical Software Package (STATA) version 17.0. RESULTS: A total of 33 research articles were included in this systematic review and meta-analysis. Escherichia coli, Klebsiella species, Acinetobacter, and Pseudomonas species were the most frequently reported bacteria from two or more sources. More than 50% of Klebsiella species and 25% to 89% of Escherichia coli from two or more sources were resistant to all analysed antibiotics, except carbapenems. Fifty-five percent (55%) to 84% of Acinetobacter species and 33% to 79% of Pseudomonas species from human and environmental sources were resistant to all analyzed antibiotics. Carbapenem resistance was common in Acinetobacter and Pseudomonas species (38% to 64%) but uncommon in Enterobacteriaceae (19% to 44%). Acinetobacter species (92%), Klebsiella species (86%), and Pseudomonas species (79%) from human sources, and Proteus species (92%), and Acinetobacter species (83%), from environmental sources, were the common multidrug-resistant isolates. About 45% to 67% of E. coli, Klebsiella, Acinetobacter, and Pseudomonas species from human and environmental sources were ESBL producers. CONCLUSION: Our review report concluded that there was a significant pooled prevalence of drug resistance, MDR, and ESBL-producing Enterobacteriaceae, Acinetobacter, and Pseudomonas species from two or more sources. Hence, our finding underlines the need for the implementation of integrated intervention approaches to address the gaps in reducing the emergence and spread of antibiotic- resistant bacteria.

SARS-CoV-2 Infections, Clinical Characteristics, and Related Risk Factors: The First 8 Months Surveillance Study Conducted in Southwest Ethiopia.

Coronavirus disease 2019 (COVID-19) is caused by a severe acute respiratory syndrome coronavirus (SARS-CoV-2) and became pandemic after emerging in Wuhan, China, in December 2019. We aimed to investigate the prevalence, clinical characteristics, and risk factors for SARS-CoV-2 infections in districts of southwest Ethiopia. A study was conducted on COVID-19 surveillance data in the diagnostic center of the southwest district of Ethiopia from July 1, 2020, to February 30, 2021. A total of 10 618 nasopharyngeal specimens were tested for SARS-COV-2 using the detection of unique sequences of virus RNA by reverse transcriptase PCR. Data were entered into Epidata version 3.1 and analyzed using SPSS version 25. Logistic regression was used to determine the relationship between COVID-19 and risk factors, with a significance level of P = 0.05. A total of 10 618 individuals were tested for SARS-CoV-2. Of these, 419 (3.9%) patients tested positive for SARS-CoV-2. Among a total of 419 patients who tested positive for SARS-CoV-2, 80.2% were asymptomatic, 264 (63.0%) were males, and 233 (55.6%) were aged 19 to 35 years. Comorbidity was present in 37 (8.8%). The risk of getting SARS-CoV-2 infections was increased with male sex (AOR = 1.248; 95% CI: 1.007, 1.547), health workers (AOR = 3.187; 95% CI: 1.960, 5.182), prisoners (AOR = 2.118; 95% CI: 1.104, 4.062), and comorbid conditions (AOR = 2.972; 95% CI: 1.649, 5.358), such as diabetes (AOR = 4.765; 95% CI: 1.977-11.485) and other respiratory problems (AOR = 3.267; 95% CI: 1.146-9.317). Despite the fact that overall laboratories confirmed prevalence of SARS-CoV-2 infections in the study area was low and dynamic, it was spread to all zones of the study area. This highlights the importance of implementing the most effective public health strategies to prevent the further spread and reduce the burden of SARS-CoV-2 infections.

Detection of Mycobacterium tuberculosis using Gene Xpert-MTB/RIF assay among tuberculosis suspected patients at Mizan-Tepi university teaching hospital, southwest Ethiopia: An institution based cross-sectional study.

BACKGROUND: Consistently deciding its current extent and chance elements of tuberculosis (TB) in all levels of clinical settings contributes to the anticipation and control exertion of the disease. In Ethiopia, updated information is still needed at every healthcare level and in different risk groups to monitor the national program's performance, which aims to attain the 2035 goal. Hence, this study aimed to generate additional evidence data on the magnitude of Mycobacterium tuberculosis using the Gene Xpert assay among TB-suspected patients at Mizan-Tepi university teaching hospital, southwest Ethiopia. METHODS: A cross-sectional descriptive study was conducted from June to September 30, 2021. The required socio-demographic and other risk factor data were collected from a total of 422 suspected TB patients using a structured questionnaire. Approximately 392 pulmonary and 30 extra-pulmonary samples were collected and examined using the Gene Xpert-MTB/RIF assay. The statistical package for social sciences (SPSS) version 25 software was used to analyze the data. RESULTS: In this study, Mycobacterium tuberculosis was detected in 12.5% (49/392) of pulmonary samples and 13.3% (4/30) of extra-pulmonary samples, giving an overall TB positivity of 12.6% (53/422). Rifampicin-resistant M. tuberculosis was detected in 3/53 (5.7%). Male sex (AOR: 2.54; 95% CI: 1.210, 5.354), previous contact (AOR: 4.25; 95% CI: 1.790, 10.092), smoking cigarette (AOR: 4.708; 95% CI: 1.004, 22.081), being HIV-positive (AOR: 4.27; 95% CI: 1.606, 11.344), and malnutrition (AOR: 3.55; 95% CI: 1.175, 10.747) were all significantly associated with M. tuberculosis detection using the GeneXpert MTB/RIF assay. CONCLUSION: The overall frequency of M. tuberculosis in this study was still significant in different risk groups, despite the proposed strategies, which aimed to reduce TB prevalence to as low as 10 per 100,000 populations by 2035. Early case detection with better diagnostic tools and public health measures are important prevention and control strategies to meet the proposed target and reduce the burden of TB in the country.

Assessment of Bacterial Profiles and Antimicrobial Susceptibility Pattern of Isolates Among Patients Diagnosed with Surgical Site Infections at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia: A Prospective Observational Cohort Study.

Background: Although emergency health-care services, particularly clinical and surgical care, are an important part of the provision of high quality health care in Ethiopia, infections related with surgical care are still the most well-known medical services-related diseases. This study aimed to assess the bacterial profiles and antimicrobial susceptibility pattern of isolates among patients diagnosed with surgical site infections at Mizan-Tepi university teaching hospital, southwest Ethiopia. Methodology: A prospective observational cohort study was conducted from June to September 2021. Patient data were collected using a structured questionnaire. Follow-up of patients who had undergone a surgical procedure was conducted for at least 30 days. Wound swabs were collected from patients suspected to have surgical site infections (SSIs) and cultured onto appropriate culture media. The antimicrobial susceptibility testing was done using the disk diffusion technique. Data were analyzed using SPSS software version 25.0. Frequencies and cross-tabulation were used to summarize descriptive statistics. Results: In this study, the postoperative SSIs rate was 12.6%. All patients with SSIs were culture positive, and a total of 41 bacterial isolates were detected. Of these, 73.2% were Gram-negative, 26.8% were Gram-positive and 24.2% were a mixture of two bacterial growths. Escherichia coli accounted for 29.3%, followed by Staphylococcus aureus (19.5%), Proteus species (14.6%) and Pseudomonas aeruginosa (12.2%). With the exceptions of amikacin and meropenem, which exhibited very high sensitivity, ranging from 33.3-100.0% isolates was resistant against all other tested antibiotics. The resistance rate to three or more classes of antibiotics was 100.0%. Conclusion: In this study, the most isolated bacteria causing SSIs were Gram-negative and multidrug-resistant strains. This event highlights that surveillance of the bacterial profile and antibiotic susceptibility pattern coupled with the implementation of the strict protocol for antibiotic use and operative room regulations is important to minimize the burden of SSIs.

Drug- and Multidrug-Resistance Pattern of Enterobacteriaceae Isolated from Droppings of Healthy Chickens on a Poultry Farm in Southwest Ethiopia.

BACKGROUND: In Ethiopia, the precise attribution of animals and their food products as the sources of resistant strains and the consequences of it on human health have not yet been seriously evaluated. Therefore, the aim of this study was to assess the drug- and multidrug-resistance pattern of Enterobacteriaceae isolated from chicken droppings at Jimma University poultry farm, College of Agriculture and Veterinary Medicine, southwest of Ethiopia. METHODS: A cross-sectional descriptive study was conducted from April, 2018 to June, 2018. A total of 140 fresh chicken dropping samples were collected and transported to Jimma University Medical Microbiology Laboratory for analysis. All samples were inoculated on MacConkey agar and xylose lysine deoxycholate agar. Gram stain and relevant biochemical tests were done for identification of isolates. Antimicrobial susceptibilities were tested by the Kirby-Bauer disk diffusion method. RESULTS: Out of 140 chicken dropping samples, 61 (43.6%) showed bacterial growth. Of these, E. coli accounts for 39.0% followed by K. pneumoniae (22.0%), P. mirabilis (19.3%), and Salmonella species (17.7%). With regard to antibiotic resistance pattern, E. coli demonstrated a high rate of resistance against ampicillin (91.7%), tetracycline (75.0%), and trimethoprim-sulfamethoxazole (70.8%). K. pneumoniae showed a high resistance rate against ampicillin, trimethoprim-sulfamethoxazole, and tetracycline, with a resistance rate ranging from 76.9% to 85.6%. P. mirabilis and Salmonella spp. also showed high resistance against ampicillin, tetracycline, and trimethoprim-sulfamethoxazole with a resistance rate ranging from 72.7% to 83.3%. All isolates relatively showed lower resistance rates with a range of 20.8% to 41.7% against third-generation cephalosporins (ceftazidime and ceftriaxone), ciprofloxacin, and gentamicin. Totally, 32 (52.5%) of the isolates showed MDR against three or more antibiotics. CONCLUSION: Antibiotic resistant isolates against commonly prescribed single and multiple drugs were common. This highlights that chickens in the farm may serve as the reservoirs of antibacterial resistant bacteria that might infect humans through the food chain. Therefore, emphasis on the usage of antibiotics in chicken farms has to be considered.

Individual, socio-cultural, and health facility factors affecting men's involvement in facility-based childbirth in Southwest, Ethiopia: A mixed method study.

INTRODUCTION: Traditionally, men are not supposed to take part in maternal health issues in many cultures. Nevertheless, pregnancy care and childbirth are the most crucial matters of reproductive health influenced by men. Hence, the aim of this study was to identify individual, sociocultural, and health facility factors affecting men's involvement in facility-based childbirth in Southwest, Ethiopia. OBJECTIVES: The aim of this study was to identify individual, sociocultural, and health facility factors affecting men's involvement in facility-based childbirth in Southwest, Ethiopia. METHODS: A community-based cross-sectional study accompanied with a qualitative method was carried out from 1 July to 30 August 2019. A multistage cluster sampling technique was employed to recruit study participants. Descriptive statistics, frequencies, proportions, and mean were calculated, and the results of the analysis were presented in text, tables, and graphs. A multivariate logistic regression model was fitted to investigate the independent effect of each explanatory variable on the likelihood of men's involvement in facility-based childbirth. Qualitative data were analyzed thematically using OpenCode 4.0 software. RESULTS: Out of 800 men, only 36.5% (95% confidence interval: 33.3%-39.6%) were found to have involved in facility-based childbirth. Several factors were associated with men's involvement in facility-based childbirth of this, being in the age group of 40-49 (adjusted odds ratio 5.04, 95% confidence interval: 2.49-10.20), attaining secondary education and above (adjusted odds ratio 2.14, 95% confidence interval: 1.53-5.60), and having sufficient knowledge of danger signs during pregnancy (adjusted odds ratio 5.65, 95% confidence interval: 3.25-7.46) associated with men's involvement in facility-based childbirth. CONCLUSION: Relevant entities had better design-specific educational programs targeting younger age groups, those with lower schooling, and had previous bad obstetrics outcomes. Involving elders and religious leaders in the reproductive health program could also help in overcoming the existing cultural barriers. Moreover, creating a men-friendly facility environment and extensively engaging medias are suggested to improve men's involvement in the study area.

Prevalence of multidrug-resistant and extended-spectrum beta-lactamase (ESBL)-producing gram-negative bacilli: A meta-analysis report in Ethiopia.

Multidrug-resistant (MDR) extended-spectrum beta-lactamase (ESBL)-producing bacterial isolates have emerged as a global threat to human health. Little is known about the overall prevalence of multidrug resistance profile and ESBL-producing gram-negative bacilli (GNB) in Ethiopia. Therefore, this meta-analysis was performed to produce proportional estimates of multidrug resistance and ESBL-producing GNB in Ethiopia. A web-based search was conducted in PubMed, Google Scholar, Research Gate, Scopus and other databases. Articles published till 2019 on the prevalence and antimicrobial resistance profiles of ESBL-producing GNB in Ethiopia were included in the study. Relevant data were extracted and statistical analysis was performed using comprehensive meta-analysis version 3.3.0 software. Publication bias was analyzed and presented with funnel plots. In this meta-analysis, the overall proportional estimate of ESBL-producing GNB was 48.9% (95% confidence interval [CI]: 0.402, 0.577). The pooled proportional estimates of ESBL-producing Klebsiella pneumoniae, Escherichia coli and other GNB were 61.8%, 41.2% and 42.9%, respectively. Regarding antimicrobial resistance profiles against selected drugs, the pooled proportional estimates of resistance against amoxicillin-clavulanic acid, trimethoprim-sulfamethoxazole, cefotaxime, ceftazidime, tetracycline, gentamicin and ciprofloxacin was 79.0%, 78.4%, 78.0%, 72.4%, 72.7%, 58.9% and 43.8%, respectively. The pooled proportional estimates of MDR isolates were found to be 82.7% (95% CI: 0.726, 0.896), which are relatively high as compared to other countries. This highlights a need for active surveillance systems which can help understand the actual epidemiology of ESBL, aid in formulating national guidelines for proper screening of ESBL and support developing standardized approaches for managing patients colonized with ESBL.

Low Tuberculosis (TB) Case Detection: A Health Facility-Based Study of Possible Obstacles in Kaffa Zone, Southwest District of Ethiopia.

BACKGROUND: In Ethiopia, the national TB case detection rate is becoming improved; still some districts are not able to meet their case detection targets which leads to ongoing spread of TB infections to family members and communities. This study was intended to assess possible obstacles contributing to low TB case detection in Kaffa zone, Southwest Ethiopia. METHODS: A cross-sectional descriptive study involving qualitative and quantitative data was conducted from Mar. to Sep. 2019. Sociodemographic characteristics and data on duration of cough, whether sputum smear microscopy was requested or not, and data on TB knowledge and health care-seeking practice were collected from outpatients. Health care delivery barrier for TB case detection was also explored by using in-depth interview and FGD of health staff. RESULTS: From 802 outpatients with coughing for 2 or more weeks of duration, 334 (41.6%) of them were not requested to have TB microscopic diagnosis. Of these, 11/324 (3.4%) of them were positive for TB after sputum smear microscopy. Only 24.2% of the outpatients were aware as they have had health education on TB disease. Twenty-eight percent of patients perceived that TB was due to exposure to cold air, and 13.5% could not mention any sign or symptom of TB. Amazingly, 54.2% of them did not have any information as current TB diagnosis and treatment is free. Thirty-five percent of the patients were taking antibiotics before visiting the health facility. The interrupted supply of TB diagnostic reagents, frequent electricity interruption, shortage of trained TB care providers, weak health information system, and weak active case finding practice were explored as the factors contributing to low TB case detection. CONCLUSION: Interrupted functioning of diagnostic centers, shortage of trained care providers, limited active TB case finding practice, weak health information system, and inadequate knowledge and health care-seeking practice of the patients were identified as contributors for low TB case detection. Thus, improving functioning of diagnostic centers, active TB case finding activities, and expanding health education on TB disease will help to improve TB case detection in the districts.

Assessment of extended-spectrum ß-lactamase (ESBLs) - producing Escherichia coli from minced meat of cattle and swab samples and hygienic status of meat retailer shops in Jimma town, Southwest Ethiopia.

BACKGROUND: The impact of animals sources of food as a possible reservoir for extended-spectrum ß-lactamase (ESBL) - Producing E. coli, and the dissemination of such strains into the food production chain need to be assessed. This study was aimed to assess the presence and antimicrobial susceptibility patterns of ESBLs - producing E. coli isolates from minced meat and environmental swab samples at meat retailer shops of Jimma town, Southwest Ethiopia. METHODOLOGY: A cross-sectional descriptive study was conducted from March to June, 2016. A total of 168 minced meat and swab samples were first enriched by buffered peptone water (BPW) for overnight and streaked onto MacConkey agar. Double disk synergy (DDS) method was used for detection of ESBL-producing strains. A disk of amoxicillin + clavulanic acid (20/10 µg) was placed in the center of Mueller-Hinton agar plate, and cefotaxime (30 µg) and ceftazidime (30 µg) were placed at a distance of 20 mm from the central disk. Checklist was used to assess hygienic status of butcher shops and practices meat handlers. RESULTS: A total of 35 (20.80%) biochemically confirmed E. coli were obtained from 168 samples. Of these, 21 (23.9%) of them were detected from 88 minced meat and the other 14 (17.5%) from 80 swab samples taken from butcher's hand, knives, chopping board and protective clothing. From 35 E. coli isolates, 7(20%) of them were confirmed as ESBL- producers. Among ESBL- producing strains, 85.7% were resistant for cefotaxime and ceftriaxone and 71.4% for ceftazidime. Among non-ESBLs-producing strains only seven isolates were resistant to third generation cephalosporin. All E. coli isolates were resistant to ampicillin, penicillin and erythromycin, and susceptible to amikacin. Poor hygienic status of butcher shops and unhygienic practice of meat handlers were observed. CONCLUSION: The detections of ESBLs- producing strains could be contributed for the increment of multi drug resistant isolates. This study also concluded that, unhygienic meat handling and processing practice can contribute for contaminations of meat. Thus, strategies should be planned and implemented to improve the knowledge and practice of butchers about handling and processing of meat.

Isolation of Extended-Spectrum ß-lactamase- (ESBL-) Producing Escherichia coli and Klebsiella pneumoniae from Patients with Community-Onset Urinary Tract Infections in Jimma University Specialized Hospital, Southwest Ethiopia.

BACKGROUND: Klebsiella pneumoniae and Escherichia coli are the major extended-spectrum ß-lactamase- (ESBL-) producing organisms increasingly isolated as causes of complicated urinary tract infections and remain an important cause of failure of therapy with cephalosporins and have serious infection control consequence. OBJECTIVE: To assess the prevalence and antibiotics resistance patterns of ESBL-producing Escherichia coli and Klebsiella pneumoniae from community-onset urinary tract infections in Jimma University Specialized hospital, Southwest Ethiopia, 2016. METHODOLOGY: A hospital-based cross-sectional study was conducted, and a total of 342 urine samples were cultured on MacConkey agar for the detection of etiologic agents. Double-disk synergy (DDS) methods were used for detection of ESBL-producing strains. A disc of amoxicillin + clavulanic acid (20/10 µg) was placed in the center of the Mueller-Hinton agar plate, and cefotaxime (30 µg) and ceftazidime (30 µg) were placed at a distance of 20 mm (center to center) from the amoxicillin + clavulanic acid disc. Enhanced inhibition zone of any of the cephalosporin discs on the side facing amoxicillin + clavulanic acid was considered as ESBL producer. RESULTS: In the current study, ESBL-producing phenotypes were detected in 23% (n = 17) of urinary isolates, of which Escherichia coli accounts for 76.5% (n = 13) and K. pneumoniae for 23.5% (n = 4). ESBL-producing phenotypes showed high resistance to cefotaxime (100%), ceftriaxone (100%), and ceftazidime (70.6%), while both ESBL-producing and non-ESBL-producing isolates showed low resistance to amikacin (9.5%), and no resistance was seen with imipenem. In the risk factors analysis, previous antibiotic use more than two cycles in the previous year (odds ratio (OR), 6.238; 95% confidence interval (CI), 1.257-30.957; p = 0.025) and recurrent UTI more than two cycles in the last 6 months or more than three cycles in the last year (OR, 7.356; 95% CI, 1.429-37.867; p = 0.017) were found to be significantly associated with the ESBL-producing groups. CONCLUSION: Extended-spectrum ß-lactamases- (ESBL-)producing strain was detected in urinary tract isolates. The occurrence of multidrug resistance to the third-generation cephalosporins, aminoglycosides, fluoroquinolones, trimethoprim-sulfamethoxazole, and tetracyclines is more common among ESBL producers. Thus, detecting and reporting of ESBL-producing organisms have paramount importance in the clinical decision-making.