ABSTRACT
Bacteriuria is identified when urine specimens have at least 105 cfu/ml of a uropathogen isolated in the absence of signs or symptoms of urinary infection. Urinary Tract Infection (UTI) is defined as the microbial invasion of any of the tissues of the urinary tract extending from the renal cortex to the urethral meatus. Females are however believed to be more affected than males. This is due to the short and wider female urethra and its proximity to the anus. The most commonly isolated microorganism in bacterial UTI are the Gram negative bacilli including E. coli, Citrobacter spp., Enterobacter aerogenes, Pseudomonas aeruginosa, Proteus spp., Klebsiella spp. The Gram postive bacterial UTI are Enteroccocus spp and Staphlococcus spp. There are two major modes of bacterial entry into the genitourinary tract, ascending route and hematogenous route. To establish the diagnosis of bacteriuria, a urine specimen for culture is necessary. Treatment of UTI with the appropriate antibiotic can minimize mortality, morbidity and any renal damage from acute UTI. Antimicrobial resistance is as a result of overuse, misuse and in many cases abuse of drugs. The midstream portion of urine is then collected in plastic sterile, wide-mouthed container which should be covered with a tightly fitted lid. The media used for this study were MaConkey agar, Nutrient agar, Maueller Hinton Agar and Mannitol salt agar. The bacterial isolates were identified based on their colonial morphology, cultural charaterictics, Gram stain reaction and biochemical tests. Antimicrobial sensitivity testing was performed. The result of this study revealed that Escherichia coli is the most prevalence bacteria with 41%. This study shows the necessity of obtaining sensitivity test reports before the start of antibiotic treatment in case of suspected urinary tract infection.
TABLE OF CONTENTS
Title i
Certification ii
Dedication iii
Acknowledgments iv
Table
of contents v
List of
tables vi
Abstract vii
CHAPTER
ONE 1
1.0 INTRODUCTION 1
1.1 Aims and Objectives 3
1.1.1 Specific objectives 3
CHAPTER
TWO
2.0 LITERATURE REVIEW 4
2.1 Microorganisms found in urine and their
etiology 4
2.1.1
Bacteria 4
2.1.2 Fungi and virus 5
2.1.3 Protozoa 6
2.2 Routes
of bacterial infection 6
2.2.1 The ascending route 6
2.2.2 Hematogenous route 6
2.3 Symptomatic
and Asymptomatic bacteriuria 7
2.4 Diagnosis
of UTI 8
2.5 Treatment of UTI 9
2.6 Prevention 10
2.7 Antimicrobial
resistance 11
2.7.1
Conditions affecting the effectiveness of antimicrobial agents 11
2.8 Actions
of antimicrobial drugs 12
2.8.1 Inhibitors
of cell wall synthesis 13
2.8.2 Inhibition of protein synthesis 14
2.8.3 Inhibition of cell membrane 15
2.8.4 Inhibition
of nucleic acid synthesis 16
CHAPTER THREE
3.0
MATERIALS AND METHODS 17
3.1 Sample collection 17
3.2 Sterilization of
media and materials 17
3.3 Inoculation of
urine samples and isolation of bacteria isolates. 18
3.4 Identification of
isolates 18
3.5 Antimicrobial
sensitivity testing 18
3.6 Biochemical tests 19
3.6.1 Catalase test 19
3.6.2 Oxidase test 19
3.6.3 Coagulase test 19
3.6.4 Citrate test 20
3.6.5 Indole test 20
3.6.6 Motility test 20
3.6.7 Methyl Red Test 21
3.7.8 Voges-proskauer Test 21
CHAPTER
FOUR
4.0 RESULT 22
CHAPTER
FIVE
5.0 DISCUSSION, CONCLUSION AND
RECOMMENDATIONS 28
5.1 Discussion 28
5.2 Conclusion 29
5.3 Recommendations 30
References 31
LIST
OF TABLES
Tables Title Pages
1 Identification
and characterization of bacterial isolates from urine samples
of MOUAU students. 23
2 Distribution
and Percentage of occurrence of bacteria isolated from urine
samples of MOUAU students according to sex and locations. 24
3 Frequency
of bacterial isolates from urine samples of MOUAU students according to sex. 25
4 Antimicrobial
susceptibility of Gram negative bacteria isolated from Urine
samples of MOUAU students. 26
5 Antimicrobial
susceptibility of Gram positive bacteria isolated from Urine
samples of MOUAU students. 27
CHAPTER
ONE
1.0 INTRODUCTION
Urine
is a liquid by product of the body secreted by the kidney through a process
called urination and excreted through urethra (Akobi et al.,2014). Bacteriuria is identified when urine specimens have
at least 105 cfu/ml of a uropathogen isolated in the absence of
signs or symptoms of urinary infection. The host immune response is less
vigorous with bacteriuria than with symptomatic infection (Nicolle, 2014). Urinary Tract Infection (UTI) is defined as the microbial
invasion of any of the tissues of the urinary tract extending from the renal
cortex to the urethral meatus. The urinary tract includes the organs that collect
and store urine and releases it from the body, and these organs are the
kidneys, ureters, bladder, urethra and accessory structures (Ogbukagu et al., 2016). UTI can also be defined
as the condition in which actively-multiplying bacteria persist in the
urine at any point from kidney to the urethral meatus. It is the presence of a
significant level of bacteria in urine typically 104 to 106
colony forming units (CFU/ml). UTIs may be with symptoms, that is, symptomatic
or without symptom, that is, asymptomatic (Oluwole and Adeyemi. 2016).
Asymptomatic bacteriuria, also referred to
as Bacteriuria or asymptomatic urinary infection, is a common finding in
healthy women, and in both men and women with abnormalities of the genitourinary
tract.
However, although not in all cases, there
is propensity for bacteriuria to become symptomatic if left untreated. Escherichia
coli has been reported as the most prominent bacteria associated with
bacteriuria but an increased percent of Proteus, Klebsiella, Enterococcus,
and Pseudomonas has also been identified (Oluwole and Adeyemi. 2016).
Infection of the urinary tract system however,
occurs when too much bacteria especially those that inhabit the
gastrointestinal tract and the skin enter the vagina through the anus and
thrive inside the urinary system (kidney, urethra, bladder and urethras) and
consequently reproduce rapidly due to available nutrients. Infection of the
urinary tract could manifest differently depending on the site of the infection
and length of time involved, those that affect the lower urinary tract are
called the cystitis- involving the bladder alone with symptoms including
painful urination, burning sensation, either frequent or urge to urinate (or
both), while those that affect upper urinary tract are the pyelonephritis
involving the kidney and other organs. The symptoms of the upper urinary tract
include; fever and flank pain during urination in addition to those of the
lower urinary tract (Ogomaka et al.,2014).
Numerous reports have suggested that UTI can occur in both males and females of
any age, with bacterial counts as low as 100 colony forming units (CFU) per
milliliter in urine. Females are however believed to be more affected than
males. This is due to the short and wider female urethra and its proximity to
the anus. The female urethra is also adjacent to the genital and intestinal
tracts. Bacteria from the rectum can easily travel up the urethra and quickly
gain access to the bladder and cause infections (Amaeze et al.,2013).
The
choice of medication and length of treatment depend on the patient’s history
and the type of bacteria causing the infection. Indiscriminate and extensive
use of antibiotics, however, results in the development of resistant strains
which in recent years have become major health problem to medical practitioners
and to the public at large. Hence it becomes necessary that to effectively
treat and control infections such as UTIs by health
care provider, a good knowledge of the antibiotic sensitivity pattern of the
causative organisms should be ascertained before drug administration (Ogomaka et al.,2014)
Drug resistance among bacteria causing UTI
has increased since the introduction of UTI chemotherapy, the etiological agent
and their susceptibility patterns of UTIs vary in regional and
geographical
location, besides, the etiology and drug resistance change through time.
Knowledge of the local bacterial etiology and susceptibility patterns is
required to trace any change that might have occurred in time so that updated
recommendation for optimal empirical therapy of UTI can be made (Onuoha and
Fatokun, 2014). Antibiotics are used for prophylaxis
of recurrent UTIs but can lead to emergence of drug-resistant bacteria.
Knowledge about the type of pathogens responsible for UTIs and their
susceptibility patterns may help the clinicians to choose the right empirical
treatment (Ogbukagu et al.,2016).
1.1 AIMS AND OBJECTIVES
To
find out the prevalence and antimicrobial susceptibility of bacteria in urine
samples of students of Michael Okpara University of Agriculture Umudike,
Umuahia, Abia State.
1.1.1
specific
objectives
·
To isolate bacteria from
urine samples.
·
To identify the isolates.
·
To determine the occurrence
of the isolates.
·
To determine the
sensitivity pattern of the isolates.
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