Abstract:

INTRODUCTION

Urinary Tract Infection (UTI) is a significant health problem worldwide, affecting all ages and both sexes. Hence, the need for determination of microorganisms causing urinary tract infection (UTI) and their in-vitro susceptibility test is of paramount important to improve service delivery to patients. With this background, a retrospective study was carried out from July 2013 to December 2013 at National Hospital Abuja (NHA).

OBJECTIVE

This study is planned to determine the prevalence of urinary tract infection (UTI) among different sexes and age groups as well as the predominant bacterial pathogens and their sensitivity to antibiotics so as to guide empirical antibiotic therapy. This is aimed at providing improved patient care and management.

MATERIALS AND METHODS

A total of 2640 urine samples from patients attending both inpatient and Outpatient departments of NHA were included in this study. Data of all patients who had positive urine culture between July 2013 and December 2013 were systematically and retrospectively collected from the Laboratory register of the Medical Microbiology and Parasitology Department. Demographic data of these selected individuals’ patient, sex, marital status, pathogens isolated and their antimicrobial sensitivity pattern were collated and analyse. These urine samples were earlier subjected to culture and sensitivity test with the use of standard bacteriological techniques as described by American Society for Microbiology (ASM).

RESULTS

Twenty five percent of the total urine samples (2640) showed significant bacterial growth. Ten different bacterial species were isolated. Among these, Escherichia coli (49.5%) was significantly the most predominant one (P<0.05) followed by Staphylococcus aureus (14.9%), Klebsiella spp (11.8%), Enterococcus faecalis (8.9%), Pseudomonas aeruginosa (4.4%), Proteus spp (3.3%) and others. Majority of Gram-negative bacteria showed susceptibility towards Ciprofloxacin, Gentamicin, and Amikacin. The age group with highest frequency of UTIs was 21–30 years with females predominating in all the age groups except in less than 1 and above 60 years (Fig. 7). The results showed that married women are more likely to be affected than their single or widowed counterparts while the reverse was the case in males (Fig. 8).

CONCLUSION

This outcome of this study shows that there is need for more work in this area be to consistently determine the changing pattern of microbial uropathogens and their antimicrobial profiles.

References:

1.      Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing, 17th informational supplement. Wayne, PA: CLSI.2007; M100-S17.

2.      Chattopadhya AK and Mandal AK. Microbes associated with urinary tract infection in Burdwan, West Bengal. Ind J physiology and Allied Science 1993; 47:67-72.

3.      Cheesbrough, M. District Laboratory Practice in Tropical Countries. Part 2. Cambridge University Press: Cambridge, UK. 2002; 105-112.

4.      De Francesco, M.A., R. Guiseppe, P. Laura, N. Ricardo and M. Nino. Urinary tract infection in Brescia, Italy: Etiology of Uropathogens and antimicrobial resistance of common uropathogens Med. Sci Monit., 2007; 13:136-144.

5.      El-Sweih N, Jamal W, Rotimi VO. Spectrum and antibiotic resistance of uropathogens isolated from hospital and community patients with urinary tract infections in two large hospitals in Kuwait. Med. Principl. pract. 2008; 14: 401-407.

6.      Esko E and Renkonen OV. Comparative in vitro activity of Norfloxacin and 7 other antimicrobial agents against clinical isolates from urinary tract infection. Scand J Infect Dis 1985; 17:95-8.

7.      Forbes BA, Sahm DF and Weissfeld AS. Bailey and Scott’s Diagnostic Microbiology (11th ed). USA: Mosby 2002.

8.      Foster, R.T., Sr. “Uncomplicated Urinary Tract Infection in Women”. Obstet Gynecol Clin., North Am. 2008; 35(2):235-48.

9.      Fowler JE. Urinary tract infections in women. Urol. Clin. North Am. 1986; 13: 673-676

10.  Fowler, J.E. “Urinary Tract Infection in Women”. J. of Urol. Clin. of North Am. 1996; 11:67-68.

11.  Foxman B, Barlow R, D’Arcy H, et al. Urinary tract infection: Self-reported incidence and associated costs. Ann Epidemiol 2000; 10:509–15.

12.  Gluisier MPC. Urinary tract infection and pyelonephritis. In: Medical Microbiology and Infectious Diseases, Braude AIP, Sander WB (ed.), WB Comp. Philadelphia 1991; pp. 1172-1183.

13.  Gupta K. Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Int. J. Antimicrob. Agents. 2001; 135: 41-50

14.  Henry D. Isenberg. Clinical Microbiology Procedures Handbook (2nd ed). Washington, D.C.: ASM press 2004.

15.  Karki A, Tiwari BR and Pradhan SB. Study on Bacteria isolated from Urinary tract infection and their sensitivity pattern. J Nep Med Assoc 2004; 43:200-3.

16.  Kunin CM. Urinary tract infections in females. Clin. Infect. Dis. 1994; 18: 1-12.

17.  Kolawale AS, Kolawale OM, Kandaki-Olukemi YT, Babatunde SK, Durowade KA, Kplawale CF. Prevalence of urinary tract infections among patients attending Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria. Int. J. Med. Med. Sci. 2009; 1(5):163-167

18.  Leegard, T.M., D.A. Caugant, L.O. Froholm and E.A. Hoiby, Apparent difference in antimicrobial susceptibility as a consequence of national guidelines. Clin Microbiol Infect., 2000; 6:290

19.  Levitt PN. Analysis of pathogens isolated from urinary tract infection in Barbados. West Indi Med J 1993; 42:72-6.

20.  Lin, K. and K. Fajardo. “US Preventive Services Task Force. Screening for Asymptomatic Bacteriuria in Adults”. Ann. Intern. Med. 2008; 149 (1): 20-4.

21.  Mbata TI. Prevalence and antibiogram of UTIs among prison inmates in Nigeria. Int. J. Microbiol. 2007; 3(2): 6-12.

22.  Mulugeta, K and A. Bayeh. Prevalence and antibiogram of bacterial isolates from urinary tract infections at Dessie Health research Laboratory, Ethiopia. Asian Pac. J Trop Biomed., 2014; 4(2):164-168

23.  Nicolle, L.E. “Uncomplicated Urinary Tract Infection in Adults Including Uncomplicated Pyelonephritis”. J. of Urol. Clin. of North Am. 2008; 35(1): 1-12.

24.  Norrby, S.R. “Approach to the Patient with Urinary Tract Infection”. In: Goldman L, Ausiello, D, eds. Ceil Medicine 23rd ed. Philadephia, PA. 2007; p.306.

25.  Obi CL, Tarupiwa A and Simango C. Scope of urinary pathogens isolated in the public health bacteriology laboratory. Harare: Antibiotic susceptibility patterns of isolates and incidence of haemolytic bacteria. Central African J Med 1996; 42: 244-9.

26.  Okada K, Usui Y and Wananabe R. Statistic studies on bacteria isolated from urinary tract infection (Report 6: Isolation rate and drug sensitivity from 1988 through 1989). Acta Urol Japonica 1994; 40:175-85

27.  Onuh, S.O., O.U.J. Umeora, G.O. Igberase, M.E. Azikem and E.E. Okpere. Microbiological Isolates and sensitivity pattern of Urinary tract infection in pregnancy in Benin city, Ebonyi Medical Journal., 2006; 5(2): 48-52.

28.  Pokhrel BM. A handbook of clinical microbiology (1st ed). Kathmandu: Gorakhnath desktop and printers 2004.

29.  Talukder MAS. Sensitivity pattern of positive urine culture in a Teaching Hospital. Ban Ren J 1987; 6:49-52.

30.  Simon, H. et. al. Urinary Tract Infections. http://www.reutershealth.com/wellconnected Accessed on 2001; 23/8/2008