INCIDENCE OF ASYMPTOMATIC BACTERIURIA IN FEMALE STUDENTS OF MICHAEL OKPARA UNIVERSITY OF AGRICULTURE UMUDIKE

ABSTRACT

The study was aimed at assessing asymptomatic bacteriuria among female students of Michael Okpara University of Agriculture, Umudike, Abia State. Randomly sampled clean catch midstream urine specimens were collected from 110 apparently healthy asymptomatic undergraduate female students of MOUAU between ages of 16 to 30 years. The urine specimen was cultured on Cysteine Lactose Electrolyte Deficient Agar (CLED), which is the gold standard for detecting asymptomatic bacteriuria and incubated overnight at 370C. This reveals that out of the 110 urine specimen culture, forty two (42) urine specimen showed Scanty, whitish circular growth on the media, two (2) urine specimen showed Yellowish circular growth, fourteen (14) urine specimen showed Large circular, yellowish cluster growth, twelve (12) urine specimen showed Moderate growth circular, yellowish, two (2) urine specimen showed Whitish, circular, crossed straight and forty six (46) urine specimen showed no sign of growth on the culture media.The results showed that the total prevalence rate of bacteriuria was Coagulase Negative Staphylocccus 21(32.82%) was most common uropathogen isolated followed by Escherichia coli 5(7.81%), Staphylococcus aurues 15(23.43%), Proteus species 2(3.12%), Enterococcus spp 10(15.62%), Group B Streptococcus 2(3.12%), Citrobacter spp 5(7.81%), and Klebsiella spp 3(4.68%) respectively while Pseudomonas spp 1(1.56%) had the lowest. Coagulase Negative Staphylococcus was the most common bacteria for asymptomatic bacteriuria in female university undergraduates in this study. The incidence of the bacteriuria in a healthy population is of significant public health concern as they may be incubating pathogenic microorganism which may cause disease they may be incubating pathogenic Microorganism which may cause disease when they interact with the opposite sex. Thus, education and awareness on the need for proper personal hygiene should be encouraged.

TABLE OF CONTENTS

Title Page                                                                                                                                i

Certification                                                                                                                           iii

Dedication                                                                                                                              iv

Acknowledgement                                                                                                                  v

Table of Contents                                                                                                                   vi

List of Tables                                                                                                                          vii

Abstract                                                                                                                                  ix

CHAPTER ONE: INTRODUCTION                                                                                   1

1.1       Aims and Objectives                                                                                                  2

CHAPTER TWO: LITERATURE REVIEW                                                                      4

2.1       Asymptomatic Bacteriuria                                                                                         4

2.2       Prevalence of Asymptomatic Bacteriuria                                                                  5

2.3       The Role of Asymptomatic Bacteriuria Prior to Surgery                                           6

2.4       The Role of Asymptomatic Bacteriuria in Women Affected by Recurrent

            Urinary Tract Infections                                                                                             7

2.5       Screening for Asymptomatic Bacteriuria                                                                   8

2.6       Asymptomatic Bacteriuria amongst Female Students of Rivers State

            University of Science and Technology, Port Harcourt                                              9

2.7       Asymptomatic Bacteriuria among Female Students of a Tertiary

            Institution in Southeast Nigeria                                                                                  10

2.8       Microorganisms Associated with Asymptomatic Bacteriuria                                    12

CHAPTER THREE: MATERIALS AND METHODS                                                      14

3.1       Study Area                                                                                                                  14

3.2       Study Population                                                                                                        14

3.3       Sample Collection                                                                                                      14

3.4       Microbial Analysis                                                                                                     15

3.5       Urine Microscopy                                                                                                       15

3.6       Media Used                                                                                                                 15

3.7       Sample Preparation and Isolation of Microorganisms                                               16

3.7.1    Isolation of Microorganisms                                                                                      16

CHAPTER FOUR: RESULTS                                                                                             17

CHPATER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION          20

5.1       Discussion                                                                                                                   20

5.2       Conclusion                                                                                                                  22

5.3       Recommendation                                                                                                       22

            References

LIST OF TABLES

CHAPTER ONE

1.0  INTRODUCTION

Asymptomatic bacteriuria (ASB) is variously defined as detection of significant bacterial count (single organism ≥ 10⁵/ml from voided mid-stream urine or single organism ≥ 10⁵/ml from two consecutively voided mid-stream urine from individuals who are asymptomatic for urinary tract infections (Tadesse et al., 2014). It is estimated that one in three females of childbearing age may experience asymptomatic bacteriuria. Several reports have indicated that females are more predisposed to asymptomatic bacteriuria than their male counterparts (Yeshitela et al., 2012) and this has been related in part to the anatomy of the female genitourinary system (Boye et al., 2012) as well as hormonal, and some behavioral factors. Females bear most of the ASB-related disease complications such as pyelonephritis and renal scarring. Many epidemiological studies from different geographical settings as well as in different female risk groups have associated sexual activity, number of sexual partners (Vincent et al., 2013).

It has been reported that drinking cranberry juice tends to protect women against asymptomatic bacteriuria. Many studies have provided varying reports regarding asymptomatic bacteriuria prevalence, and antimicrobial resistance (AMR) patterns among most-at-risk (MAR) groups, while other reports are divided on the most implicated uropathogen in asymptomatic bacteriuria. Meanwhile, knowledge of asymptomatic bacteriuria prevalence trends and AMR patterns of implicated uropathogens in MAR populations are indispensable for prevention and treatment of urinary tract infections (UTIs) and AMR surveillance in resource-poor settings (RPSs).

The prevalence of asymptomatic bacteriuria in children varies with location. Prevalence of 2 to 5.4% have been reported in developed countries (Nicolle, 2003) while in developing countries, prevalence of 10 to 48% have been reported (Moses et al., 2012).  Asymptomatic bacteriuria can predispose to serious morbidity and mortality in children when not detected and treated (Chukwu et al., 2011). Clinical (symptomatic) or subclinical (asymptomatic) disease that may involve just the lower tract or both the lower and upper tracts infection may involve single sites, such as urethra-urethritis, prostrate-prostitis, bladder, cystitis, kidney-pyelonephritis but the whole system is always at a risk of invasion by bacteria once any part is infected (Atlas, 2016).

In Nigeria, Elo-Ilo et al. (2013), carried out a cross-sectional survey to determine the prevalence of asymptomatic bacteriuria in pre-school children in Nnewi, South-East Nigeria. The prevalence of asymptomatic bacteriuria was significantly higher in females, being 15 times that of their male counterparts 4%. Oner et al. (2014) reported a prevalence of 3.3%. Eyong et al. (2011) studied pre-school children in Calabar, Nigeria and found a prevalence of 5.6%. Similarly, an asymptomatic bacteriuria prevalence of 7.3% was reported by Jombo et al., (2010) in a study of pre-school children in Calabar, Nigeria. Also in Nigeria, reports of higher asymptomatic bacteriuria rates include 10.3% and 15% by Wogu et al. (2011); Iduoriyekemwen et al. (2013) both in Benin City, while Alo et al. (2012) reported 48% prevalence of asymptomatic bacteriuria in rural primary school children in Ebonyi State.

1.1       AIMS AND OBJECTIVES

The aim of this study is to determine incidence of asymptomatic bacteriuria among female undergraduate students of Michael Okpara University of Agriculture, Umudike, while the specific objectives were;

1.     To determine the total number and cultural characteristics of the samples on culture media

2.     To determine the percentage occurrence of various isolates from the urine samples.

3.     To identify the bacterial agents responsible for asymptomatic bacteriuria among the female students population of Michael Okpara University of Agriculture, Umudike.

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