ABSTRACT
Gram negative bacteria are the most prevalent cause of urinary tract infection when compared to gram positive bacteria. The gram negative organisms commonly implicated are E. coli, Klebsilla spp, Staphylococcus aureus, protens spp., Psendomonas asmginosa and other gram negative bacteria. Urinary tract infection is most common among females than males and this could be explained by the short urethra of the females which make them prone to urinary tract infection. Mid stream urine samples were collected from UTI patients around MOUAU. Each specimen was cultured using standard bacteriological methods identification of gram negative organisms were made and antibiotic sensitivity testing of the gram negative isolates was carried out. A total of 30 gram negative isolates were used in the study out of which 10 (33.3%) were E. coli, 9(30%) Protens spp 6(20%) pseudomonad aeruginosa and 5(16.7%) klebsiella spp. Nitrofurantoin was the most effective antibiotic against the isolates while the isolates were highly resistant to cefixime and augmentin. E. coli was the most isolated gram negative organism isolated in thus study. Education on the importance of proper treatment of UTI to the general public cannot be over emphasized.
TABLE OF CONTENTS
Cover page i
Title page ii
Certification iii
Dedication iv
Acknowledgement v
Table of contents vi
List of tables viii
List of figures ix
Abstract x
CHAPTER ONE
1.1 Introduction 1
CHAPTER
TWO
LITERATURE
REVIEW
2.1 Antimicrobial Agents 3
2.2 Penicillin 3
2.2.1 Tetracycline 4
2.2.2 Chloramphenicol 4
2.3 Antibiotic Resistance 5
2.4 Mode of Action of Antibiotics 6
2.5 Gram Negative Bacteria 8
2.5.1. Escherichia coli 8
2.5.2. Klebsiella Specie 8
2.5.3 Proteus Species 9
2.5.4. Pseudomonas Species. 9
2.6. Urinary Tract Infections 9
2.6.1. Types of Urinary Tract Infections 10
CHAPTER THREE
MATERIALS AND METHODS
3.1 Sample Collections 11
3.2 Sterilization of
Materials 11
3.3 Isolation of bacteria
from urine Samples 11
3.4 Grem Stain Test 11
3.4.1 Biochemical tests 12
3.4.2 Catalase test 12
3.4.3 Peptone Water Sugar
Test 12
3.4.4 Antibiotic Sensitivity Testing 13
CHAPTER FOUR
4.0 Results 14
CHAPTER FIVE
5.0
Discussions 19
5.1
Conclusion 20
REFERENCE
APPENDIX 1
APPENDIX 2
LIST OF TABLES
Table 1: Identification of the gram negative bacterial isolates from urine
samples of UTI patients 15
Table 2: Antimicrobial susceptibility of the gram negative bacteria isolates
from urine samples of UTI patients. 16
LIST OF FIGURES
Figure 1: The distribution of the various gram negative isolates from urine
samples of UTI patients used in the study 17
Figure 2: The average percentage susceptibility of the isolates to the
different
antimicrobial agents 18
CHAPTER
ONE
1.1 INTRODUCTION
Gram negative bacteria important hospital pathogens, particularly
for critical patients and appropriate antimicrobial treatment is often critical
to decreasing mobility and mortality among
hospitalized patients having infections. Gram negative bacteria are non-
sporing bacilli which grow readily on ordinary
laboratory media under both aerobic and anaerobic conditions. Most of
them ferment glucose and a variety of other of sugars. (stewart et al; 1979).
Bacteria are the primary organisms that cause urinary tract
infections. Urinary tract infections are conditions where one or more
structures in the urinary tract become infected after bacteria overcome and it
is also a bacteria inflammation in the urinary tract (Stamm and Hootoni, 1993).
Urinary tract infection are more than 100 organisms per militer of
urine in a symptomatic patient or less than 100,000 organisms per milliliter of
urine in an asymptomtic patient (Haris et al., 1983). Escherichia coli accounts
for the majority of UTIs in young women but other gram negative rods of
different genera such as proteus species and enterobacter which also cause particularly in hospitalized patients
and P. aeruginosa on anaerobic gram negative rod is particularly
troublesome . Urinary tract pathogen because of its resistance to
antimicrobials medicine makes it different to tract successfully (Nester et al., 1998). A high proportion of
hospital acquired UTIs are associated with indwelling caltheters.
This device subverts several host defenses to allow bacteria entry
in the urinary tract (Warren, 1997). Any situation in which the urine does not
naturally flow increase the chance of infection. In this, circumstances, urine
accumulates and distends the elastic bladder. Even a few bacteria can multiply
to high levels, during this time causing infection.
Urine provide abundant nutrient for many species of bacteria (Nester
et al., 1998). Most cases of UTIs in
the hospitals are initially treated empirically based on the frequency of
potential pathogens, local antimicrobial resistance rate and illness severity.
The use of inappropriate empirical therapy was found to be a predication of
mortality in patients who had bacterieaemia originating from a urinary tract
source (Bishara et al., 1997).
Antibodies are used for control of bacterial infections in humans. Generally,
gram negative bacteria are sensitive to many antimicrobial agents but strains
from different patients and carriers differ in the patterns and degree of the
sensitivity to different drugs. In recent times , many strains have developed
resistance to some antibiotics, notably penicillin and its derivatives
(Adekeye, 1979).
However, very little research has been carried out on the
antimicrobial susceptibility of gram negative bacteria isolated from urine
samples. This work was therefore undertaken to determine prevalence of gram
negative bacteria to provide the antimicrobial agent useful on the best choice
of urinary tract infections treatment.
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