BACTERIA ASSOCIATED WITH URINARY TRACT INFECTION AMONG MALE STUDENTS IN A TERTIARY INSTITUTION IN ABIA STATE

 ABSTRACT

This study was carried out to evaluate the types and prevalence of bacteria causing Urinary Tract Infection (UTI) among male students in different hostel in the University. A total number of 55 randomly selected male students of MOUAU participated in this research. Diagnosis of Urinary Tract Infection (UTI) was made by Microscopic examination ,Culture, and Gram staining. Antibiotics susceptibility tests were done by disc diffusion technique. Among gram negative bacteria, the predominant isolates were the Escherichia coli 5(50%), Klebsiella pneumonia 2(20%) and proteus spp. 2(20%), while in Gram positive the main organism identified was Streptococcus spp. 1(10%). Escherichia coli were the most common cause of UTIs. Most of the bacteria tested were susceptible to the quinolones, ciprofloxacin and ofloxacin, while resistance was observed with Augmentin, and streptomycin. It will be appropriate to carry out culture and invitro sensitivity for isolates from UTI, so as to guide appropriate prescription.

TABLE OF CONTENTS

Title Page.                                                                                                                   i

Certification.                                                                                                              ii

Dedication.                                                                                                                 Iii

Acknowledgements.                                                                                                   Iv

Table of contents.                                                                                                       V

List of table.                                                                                                                Vii

Abstract.                                                                                                                     viii

CHAPTER ONE: INTRODUCTION.

1.1 Introduction.                                                                                                         1

1.2 Aim and Objectives.                                                                                             3

1.3 Research Hypothesis.                                                                                           4

CHAPTER TWO: LITERATURE REVIEW.

2.1 Literature review.                                                                                                 5

2.2 Epidemiology of UTI.                                                                                          8

2.3 Pathogenesis of UTI.                                                                                            9

2.4 Signs and symptoms                                                                                             9

2.5 Causes of UTI.                                                                                                      9

2.6 Diagnosis.                                                                                                             10

2.7 Prevention.                                                                                                            10

CHAPTER THREE: MATERIALS AND METHODS.

3.1 Materials and methods.                                                                                         12

3.2 Study population.                                                                                                 12

3.3 Collection of urine specimen.                                                                              12

3.4 Microscopic Examination.                                                                                   12

3.5 Culture.                                                                                                                 13

3.6 Gram staining.                                                                                                      13

3.7 Biochemical test.                                                                                                  14

3.7.1 Catalase test.                                                                                                      14

3.7.2 Coagulase test.                                                                                                   14

3.7.3 Oxidase test.                                                                                                      15

3.7.4 TSI.                                                                                                                    15

3.7.5 SIM.                                                                                                                   16

3.7.6 Citrate test.                                                                                                         16

3.7.7 Urease test.                                                                                                        17

3.8 Antimicrobial susceptibility testing.                                                                    18

CHAPTER FOUR: RESULTS

4.1 Results.                                                                                                                 19

CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION.

5.1 Discussion.                                                                                                                        24

5.2 Conclusion.                                                                                                                       26

5.3 Recommendation.                                                                                                            27

  REFFERENCES

APPENDIX

LIST OF TABLES

Table 1: Age distribution of participants in the study.

Table 2: Distributions of uropathogens among the positive isolates.

Table 3: Distribution of Gram-negative and positive bacteria among uropathogens.

Table 4: In-vitro Antibiotics sensitivity pattern of bacteria isolated in this study.

CHAPTER ONE

1.1 INTRODUCTION:

Urinary tract infection is one of the major diseases that affect people of all age groups and sexes and can be separated into asymptomatic and symptomatic cases based on the pathogenesis of infection (Azubike et aI., 1994). Urinary tract infections can also be categorized as ascending and descending. Infections which are confined to the urethral or the bladder are ascending and referred to as urethritis or cystitis respectively. On the other hand, the pathogens spread from another infected body site to the kidneys down along the ureter to the bladder. Such descending urinary tract infections cause severe kidney infection, a condition known as pyelonephritis (Parsons, 1985). The normal urinary tract is sterile but gets infected with the normal flora by overcoming the natural defence of the normal sterile urinary tract, thus acting as opportunistic pathogens. The diagnosis of urinary tract is usually confirmed by microscopy, culture and biochemical/serologic assays of properly collected urine samples while the treatment of an individual that is infected is based on the antibiotic sensitivity patterns to the bacteria isolated. The urinary tract infection is most commonly caused by gram-negative bacilli in the family Enterobacteriaceae and usually belongs to genera Escherichia, Proteus, Klebsiella, Enterobacter and Pseudomonas. The objective of this study is to find the pathogenic bacteria commonly associated with urinary tract infection among students living in the hostels of the University of Agriculture, Umudike, to characterize differences where they exist in the pattern of infection with respect to social and hygiene habits. It has also been observed that most of students generally abuse antimicrobial drugs whenever they suspect urinary tract infection. Thus, this study also considers antimicrobial sensitivity patterns of the pathogenic bacteria. The findings would assist the authorities of various institutions operating hostel accommodations to prevent and control urinary tract infections.

UTI (which is the microbial invasion of any of the tissues of the urinary tract extending from the renal cortex to the urethral meatus) is one of the most common infectious diseases which have been extremely studied in the field of clinical practice (Naylor, 1984). It is the most common health care – associated group of bacterial infections affecting humans in Africa (Ozumba, 2005). UTI is among the most common bacterial infections in humans both in the community and hospital settings which occur in all age groups and in both genders (Orret et al., 1999). UTI is the major cause of morbidity in both the hospital and community settings (Omigie et al., 2009) and affects both out and in patients (Suwangool, 2012). The microbiological detection of pathogenic micro-organisms in the urinary tract will confirm the existence of urinary tract infection. The infection is considered significant and requires treatment when more than 105 microorganisms (CFU/ml) of urine are present in a properly collected specimen (Tolkoff et al., 1986). Gram negative bacteria such as Escherichia coli, Proteus spp, Klebsiellaspp, Enterobacter spp, Serratia spp and Pseudomonas spp are usually detected in recurrent infections especially in association with stones, obstruction, urologic manipulation and nosocomial catheter – associated infections (Naylor, 1984). Microbial sensitivity tests are done to direct therapy of the urinary tract infection. Escherichia coli and Klebsiellaspp are the most predominant gram negative bacteria found frequently in UTI cases as reported by several authors (Ayhan et al., 1988). Other bacterial pathogens frequently isolated include Staphaureus, Staph. Epidermidis and Strept. Faecalis (Eghafona et al., 1998). For many years, pathogens associated with uncomplicated UTI have remained constant with E.coli identified as etiologic agent in about 75 – 90% of UTIs (Karlowsky et al., 2002). The remaining gram negative urinary pathogens are Klebsiellaspp, Proteus mirabilis and Pseudomonas aeruginosa. Enterococci and coagulase negative Staphylococci e.g. Staph saprophyticus are the most frequently implicated gram positive organisms.  According to Abubakar  (Abubakar, 2009), the emergence of antibiotic resistance in the management of urinary tract infections is a serious public health problem particularly in the developing countries of the world where apart from a high level of poverty, ignorance and poor hygiene practices, there is also a high prevalence of fake and spurious drugs of questionable quality in circulation. Hence, the changing spectrum of microorganisms involved in urinary tract infections and emergence of resistance across institutions and geographical areas have informed the necessity to conduct antibiotic susceptibility testing study of UTI pathogens in various regions from time to time.

1.2       AIMS AND OBJECTIVES:

The aim of this study is to find the pathogenic bacteria commonly associated with urinary tract infection among students living in the hostels of the University of Agriculture, Umudike.

 Objectives;

Ø  To isolate and identify bacteria pathogens associated with UTI.

Ø  To determine the prevalence of various isolates.

Ø  To determine the antibiotic sensitivity pattern of the isolates.

1.3       RESEARCH HYPOTHESIS:

Ø  The urinary tract infection is most commonly caused by gram-negative bacilli in the family Enterobacteriaceae.

Ø  E.coli is the most prevalent uropathogens isolated from the Urinary tract.

Ø  Most Uropathogen are resistance to the commonly used antibiotics due to misuse of these drugs.

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