Bacteriology and Antibiogram of Urinary Tract Infection Among Female Patients in a Tertiary Health Facility in South Eastern Nigeria



Angus N. Oli1, *, Vivian B. Akabueze1, Chijioke E. Ezeudu2, George U. Eleje3, Obiora S. Ejiofor4, Ifeanyichukwu U. Ezebialu5, Charlotte B. Oguejiofor3, Ifeoma M. Ekejindu6, George O. Emechebe4, Kenneth N. Okeke4
1 Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical sciences Agulu, Nnamdi Azikiwe University, Awka, Nigeria
2 Department of Peadiatrics, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra state, Nigeria
3 Department of Obstetrics and Gynaecology, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra state, Nigeria
4 Department of Peadiatrics, Chukwuemeka Odumegwu Ojukwu University, Awka Campus, Anambra state, Nigeria
5 Department of Obstetrics and Gynaecology, Chukwuemeka Odumegwu Ojukwu University Awka Campus, Anambra state, Nigeria
6 Department of Medical Laboratory Science, Faculty of Health Science and Technology, College of Science, Nnamdi Azikiwe University, Nnewi Campus, Anambra state, Nigeria


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© 2017 Oli et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical sciences Agulu, Nnamdi Azikiwe University, Awka, Nigeria; Tel: +234 8063224262; E-mails: a.n.oli@live.com; oli_an@yahoo.com


Abstract

Background:

Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the kind of pathogens implicated in urinary tract infections as well as antibiotic susceptibility profiling may help the clinician make rationally correct empirical choice in their treatment.

Objective:

This study is aimed at determining the type and antibiotic susceptibility pattern of bacterial uropathogens isolated from female patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Nigeria.

Method:

Two hundred and forty patients with clinically diagnosed UTI and who were on at least 5 days’ antibiotic holiday were recruited into the study. Their demographic characteristics were captured using pre-tested questionnaire. Their clean catch mid-stream urine samples were collected using sterile universal container and sent to the Microbiology Department for processing. Within 30 minutes of samples collection, the specimens were cultured and the isolates were identified, after 24 h of incubation, using standard microbiological techniques. Antibiotic susceptibility tests were done with standard antibiotic discs using the Kirby–bauer disc diffusion method.

Results:

Out of the 240 urine samples, 89.17% yielded significant bacteriuria. The pathogens implicated were Escherichia coli (28.5%), Staphylococcus aureus (28.0%), Salmonella spp (22.8%) and Pseudomonas aeruginosa (20.5%). HIV status, patients age, pregnancy status and marital status all significantly affected bacteriuria rate (p value < 0.05), while patients’ location (sub-urban/rural dwelling), and level of education did not (p value > 0.05). The pattern of microbial resistance to antibiotics suggests that ceftazidime, fosfomycin and cefoxitin may not be used as first-line agents in the empirical treatment of UTIs rather; levofloxacin, meropenem or aztreonam should be considered. Levofloxacin was significantly effective against all the isolates and may be administered empirically while waiting for the culture result (Mean % susceptibility was 79.85).

Conclusion:

E. coli and S. aureus were the predominant pathogens in the study and many were resistant to the commonly prescribed antibiotics and so leave the clinicians with only few alternative drugs for UTIs treatment. Routine surveillance and monitoring studies need to be constantly conducted to update clinicians on the prevalent pathogens and the rational and empirical treatment of UTIs. Aggressive and consistent health education using every possible media is also recommended to combat the menace of drug resistance occasioned by inappropriate antibiotic use.

Keywords: Bacteriology, Antibiogram, Urinary tract infection, Bacteriuria, Uropathogens.