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Background and aim Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, primarily caused by Enterobacteriaceae. The rise of carbapenem-resistant Enterobacteriaceae (CRE), complicates treatment of UTIs, yet the distribution of CRE and carbapenemase genes in Uganda's hospitals is not sufficiently explored. This study aimed to examine the distribution of carbapenemase genes in Enterobacteriaceae isolated from urinary tract infections in outpatients in southwestern Uganda. Methods A cross-sectional hospital-based study was conducted in southwestern Uganda. The study involved 111 participants who tested positive for carbapenemase genes. These participants were selected from a total of 2,371 patients presenting with urinary tract infections (UTIs) at Bwizibwera Health Center IV and Rubaya Health Center III. Enterobacteriaceaewere identified using a series of biochemical tests, and the presence of carbapenemase resistance genes (blaVIM, blaOXA-48, blaNDM, blaKPC, and blaIMP) was confirmed through polymerase chain reaction (PCR) genotyping. Data were analyzed and presented as frequencies and proportions, displayed in tables and charts. Results We screened a total of 2,371 participants with symptoms of urinary tract infections (UTI) for Enterobacteriaceae, 455 (19.2%) tested positive for at least one of the Enterobacteriaceae species. Disk susceptibility testing (DST) for carbapenems (meropenem and ertapenem) revealed a phenotypic carbapenem resistance prevalence of 5.7% (26/455), while polymerase chain reaction (PCR) identified a genotypic prevalence of 24.4% (111/455). Klebsiella spp . was the most common carbapenemase gene carrier (60/111, 54.1%), with blaIMP being the most frequent gene detected (32.4%). PCR detected more carbapenemase-producing organisms compared to DST. Notably, 14.4% of the isolates harbored multiple carbapenem resistance genes, with one sample carrying four different genes. Conclusion Our study revealed a high genotypic prevalence of CRE, especially in Klebsiella spp. and Escherichia spp. isolates with a low phenotypic expression. This suggests that relying solely on DST could miss resistant strains, emphasizing the importance of molecular diagnostics like PCR for accurate detection. Carbapenemase inhibitors should be prescribed alongside carbapenem drugs where CREs are suspected, combined with continued surveillance to help manage CRE and reduce their spread in resource-limited settings., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Research Ethics Committes of Bishop Stuart University (BSU) and the Uganda National Council of Science and Technology issued approval #BSU-REC-2023-156 and #HS3361ES. In addition, permission was sought from the district health office and the hospital in charge of Bwizibwera and Rubaya Health Centers to conduct this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Tuhamize et al.)

Background: Cancer has become a global public health challenge and the number one cause of premature death. The incidence is increasing globally and more rapidly in low and middle-income countries despite the gross under-registration and challenges in diagnosis. Data about Uganda is mostly from the Mulago cancer registry which may not entirely represent other parts of the country. This study presents the trends of cancer incidence for Southwestern Uganda in a decade (2012 to 2021)., Method: We did a review of records at the Mbarara University histopathology laboratory and Mbarara Regional Referral Oncology Clinics from January 2012 to December 2021 for cancer diagnoses. Records missing patients' age or sex were excluded., Results: We registered 4197 incident cancers, 51.8% were among males, and 10.7% were among children (0-18 years). The median age was 52 years and the interquartile range was 35-67 years. The most commonly diagnosed cancers were prostate cancer (13.46%), ocular surface carcinoma (11.03%), cervical cancer (10.55%), head and neck cancers (7.31%), esophageal carcinoma (6.79%), lymphomas (5.36%), retinoblastoma (5.31%), and breast cancer (5.00%) in descending order. Retinoblastoma was the most common cancer among children., Conclusion: The cancer pattern in Southwestern Uganda has changed and the numbers diagnosed each year are increasing. Prostate cancer is the most common diagnosed cancer overall, and the commonest cancer among men. Among women, cervical cancer is the most common cancer, followed by ocular surface carcinoma, and breast cancer. Retinoblastoma is the most common cancer among children. The trend of Kaposi sarcoma has plummeted together with ocular surface carcinomas. The cancer trends seem to be influenced by the presence of diagnostic and treatment expertise in the region., (© The East African Health Research Commission 2024.)