Background: The health and well-being of refugees are critically compromised by harsh living conditions, which foster the emergence of infectious diseases and the misuse of antimicrobial agents. This multicentre cross-sectional community-based study investigated the prevalence of urine carriage of bacteria and the associated antimicrobial resistance patterns among Syrian refugees living in makeshift camps in Lebanon, an East Mediterranean country.
Methods: We used multivariable logistic regression models to identify the risk factors associated with bacteriuria in this vulnerable population. Mid-stream urine samples were collected aseptically from 79 Syrian refugees; regardless of whether they exhibited symptoms of urinary tract infections. Samples were inoculated onto UriSelect™ 4 chromogenic agar and bacterial isolates were identified using MALDI-TOF-MS. Antibiotic susceptibility testing was assessed using the Kirby-Bauer disk diffusion assay.
Results: The prevalence of bacteriuria was 30.8% (95% CI: 21.6-41.7), and the etiologic agents were primarily Escherichia coli (80%), Klebsiella pneumoniae (12%), and Enterobacter cloacae complex (8%). The Enterobacterales isolates exhibited high resistance to penicillins (64%), cephalosporins (20-48%), and quinolones (28%), with 56% showing multidrug resistance. While the female sex and rubbish accumulation were risk factors, tea consumption, reduced chicken intake, and economic support were protective against bacteriuria.
Conclusion: This report corroborates prior anecdotal evidence regarding underdiagnosed bacteriuria among Syrian refugees in Lebanon. The data highlight the pressing need for monitoring and awareness programs to curb the spread of infectious diseases and antimicrobial resistance in both refugee and host communities.
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| http://dx.doi.org/10.1016/j.jhin.2024.12.012 | DOI Listing |
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