ABSTRACT
The aim of this study is to evaluate the urinary tract infection among female students of Michael Okpara University of Agriculture, Umudike. A total of hundred (100) mid stream urine samples were collected from female students in Michael Okpara University of Agriculture, Umudike in a sterile container and was taken immediately to the laboratory for bacteriological analysis. The mid stream urine samples were cultured on MacConkey and blood agar by streak method. This was incubated at 370C for 24hrs. Those that gave significant growth were identified by gram stain, motility and biochemical tests. Age group 21-25 years had the highest prevalence rate (62.5%), followed by age group 26-30 years (25%), while ages 16-20 years recorded the least with (12.5)%. The results show that the most common uropathogen isolated from urine of infected subject is Escherichia coli and were responsible for the cases of urinary tract infection. This was followed by Proteus (5%), Pseudomonas aeruginosa (5%), Staphylococcus saprophyticus (4%), Staphylococcus aureus (4%) while Alpha Haemolytic streptococcus (1%) had the least frequency of occurrence. On the susceptibility to the selected antibiotics, an encouraging results were obtained with Ciprofloxacin, Gentamycin and Amoxycillin/clavullanic acid. The present study revealed a high prevalence rate of UTI among female students of Michael Okpara University of Agriculture, Umudike. However, it may be necessary to improve the level of sanitation in university the community. Since UTI may be symptomatic or asymptomatic in most cases, it is therefore suggested that routine screening of patients with unexplained cases of fever be done and if UTI the appropriate antimicrobials administered after sensitivity tests have been carried out.
TABLE
OF CONTENTS
Title page i
Certification ii
Dedication iii
Acknowledgment iv
Table of content v
List of tables viii
List of figures ix
Abstract x
CHAPTER
ONE
1.1 Introduction 1
1.1 Aim and Objectives 4
1.2 Objectives 4
CHAPTER
TWO
2.0 Literature Review 5
2.1 Epidemiological of UTI 5
2.2 Aetiology 7
2.3 Bacterial UTI 7
2.4 Fungal and viral UTI 8
2.5 Modes of bacterial entry 8
2.5.1 The ascending route 9
2.5.2 Haematogenous route 9
2.6 Pathogenesis of UTI 9
2.7 Clinical manifestations of urinary tract infections 10
2.7.1 Asymptomatic bacteriuria 10
2.7.2 Cystitis 11
2.7.3 Acute pyclonephritis 11
2.8 Diagnosis of urinary tract infection 12
2.9 Laboratory detection of urinary tract infection 12
2.10 Diagnosis of urinary tract infection 13
2.11 Laboratory detection of urinary tract infection 13
2.11.1 Dipstick urinalysis 13
2.11.2 Microbiological culture 15
2.12 Treatment 16
2.13 Prevention of UTI 16
CHAPTER
THREE
3.0 Materials and Methods 18
3.1 Sample collection 18
3.2 Media to be used and its preparation 18
3.3 Sterilization 18
3.4 Enumeration of bacteria from urine samples 18
3.5 Identification and characteristics of isolates 19
3.5.1 Gram staining 19
3.5.2 Motility test 19
3.6 Biochemical culture characteristics 20
3.6.1 Catalase test 20
3.6.2 Coagulase test 20
3.6.3 Citrate test 20
3.6.4 Indole test 20
3.6.5 Triple sugar iron test 21
3.6.6 Oxidase test 21
3.6.7 Urease test 21
3.7 Antibiotics susceptibility testing 22
CHAPTER
FOUR
4.0 Results 23
CHAPTER
FIVE
5.0 Discussion,
Recommendation and Conclusion 32
5.1 Discussion 32
5.2 Conclusion 34
5.3 Recommendation 35
References
LIST
OF TABLES
Table Title Page
1
Demographic data of respondent 24
2 Microscopic examination of urine
samples 25
3
Frequency of positive isolates
from urine samples of female students
in relation to age groups 26
4
Morphology and biochemical
identification of isolate 27
5 Frequency of bacterial isolates from
female students 28
6 Distribution of bacteria
susceptibility to antibiotics 29
LIST OF FIGURES
Figures Title Page
1 Distribution of symptoms
among the sampled population 30
2 Percentage
prevalence of UTI among the sampled population 31
CHAPTER ONE
1.0 INTRODUCTION
Urinary tract infection (UTI)
is defined as the bacterial invasion of the urinary tract. Microorganisms form
a bulk of the earth’s biomass and ability to adapt to newly found environment
makes them beneficial or pathogenic (Singh et
al., 2009). Urinary tract infection are the most common of all bacterial
infections that occur at any time in the life of an individual, both in the
community and hospital settings. Although everyone is prone to UTI, it is age
and sex specific. There are specific subgroups that are at greater risk of
contracting UTI. These subgroups include infants, pregnant women, the elderly,
and patients with spinal cord injuries and/or catheters (Biering-Sørensen
et al., 2001;Ruben et al.,
1995; Winberg et al., 1974). Almost 95% of the cases of urinary tract
infections are caused by bacteria that multiply at the opening of the bladder.
Much less often, bacteria spread to the kidney from the blood stream (Hooton
and Stamm, 2007). It is primarily caused by Escherichia
coli (E.coli), accounting for 75% of bacterial UTI cases. Pseudomonas
aeruginosa and Enterococcus faecalis have
been reported as causative agents by studies in Ghana, Nigeria and other parts
of the world (Antwi et al.,
2008; Boye et al., 2012; Gyansa-Lutterodt et
al., 2014).
UTI occurs as a
result of significant microbial growth in the urinary tract, especially between
the urethra and the kidneys. Thus, the classification of UTI is based on the
site of infection. Infection of the bladder is known as cystitis, and infection
of the kidneys is called pyelonephritis. It can also be classified clinically
as either complicated or uncomplicated depending on the extent of infection (Bennett et al.,
2014). Complicated urinary tract infection is known to occur in men
and women at any point of their lives and usually has the tendency to produce
severe outcomes resulting in death in serious situations. They are highly
intricate and are difficult to treat. Complicated urinary tract infections can
lead to structural abnormalities that blight the capability of the urinary
tract to flush out the urine hence bacteria are provided with better scope for
growth (Fihn, 2003). On the contrary,
uncomplicated UTI are due to a bacterial infection, most often E. coli. They
affect women much more than men. Cystitis is the most common urinary tract
infection which occur in the lower part of the urinary tract (bladder and
urethra) and nearly always in women. In most cases the infection is brief and
acute, only the surface of the bladder is infected. Deeper layer of the bladder
may be harmed if the infection becomes persistent or chronic or if the urinary
tract infection is structurally abnormal. Pyelonephritis spread to the upper
tract (ureters and kidney) (Foster, 2008).
Globally, UTI is a major public
health burden leading to increased morbidity and the associated high healthcare
cost (Hooton et al.,
1995; Orenstein and Wong, 1999).
It is the second most common infection
among patients visiting primary healthcare facilities. In United states, where
comprehensive data is available, it is estimated that UTI accounts for seven
million hospital visits per year, with millions of those infections leading to
visits at the emergency department (Foxman, 2002). The associated cost of
health care is enormous accounting for $659 million in direct cost for treating
and $936 million in indirect cost, totaling to $1.6 billion annually (Foxman, 2002). Worldwide, it is evident that
UTI is more common among young girls, except in neonatal period where boys
predominate (Foxman, 2002). Furthermore, it is
estimated that about 20% of all women develop UTI during their lifetime (Fihn, 2003). A number of studies have been
conducted in the sub-region that suggested a range of prevalence of UTIs in
some selected populations. Reports have indicated that most of these studies
were done on febrile and malnourished infants and children below age 12 years,
with study sites being primarily hospitals and other health facilities (Wolff and
Maclennan). In addition, a few studies were done on male and females adults,
including pregnant women. In Kenyatta National Hospital, a cross sectional
study on antenatal women presenting with lower abdominal pains showed a
prevalence of 26.7% bacterial urinary tract infection (Nabbugodi, 2009).
A demonstrative study conducted at a large Ghanaian
hospital in Accra showed that 93% of isolates from urine samples were bacteria
species and 7% were yeast (Odonk et al.,
2011).Antibiotics play an important role in minimizing morbidity and mortality
associated with infectious diseases. The most common antibiotics used for the
treatment of UTI are cefuroxime, amoxicillin/clavulanic acid,
trimethoprim/sulpmethoxazole and fluoroquinolones. However, the efficacy of
these treatment is affect by bacterial resistant to many of the antibiotics
leading to treatment failure, spread of resistant bacterial strains, increased
morbidity and ultimately high cost of treatment. The extensive and
inappropriate use of antimicrobial agents has invariably resulted in the
development of antibiotic resistance which, in recent years, has become a major
public health problem worldwide (Gupta et al., 2001; MordiandErah, 2006). Furthermore, antibiotic
resistance is compounded by the unorthodox treatment of patients with suspected
UTI with antibiotics without a valid microbial culture and sensitivity
laboratory results. One way to avert this problem is detailed knowledge on the
prevalence of bacteria causing UTI and their antibiotic susceptibility pattern.
Thus, this study investigated the prevalence and antibiotic susceptibility
pattern of Uropathogenic bacteria isolated from urine samples of female
students with suspected UTI, in MOUAU.
1.1 Aim and Objectives
The aim of this study is to determine the prevalence and
antibiotic susceptibility pattern of Uropathogenic bacteria in urine samples of
patients with suspected UTI in MOUAU.
1.5 Specific objectives.
1. To determine the spectrum
of bacteria causing UTI amongst the
subjects
2. To determine the
prevalence of bacteria causing UTI amongst female students with suspected UTI
in MOUAU
3. To determine the
antibiotic susceptibility of bacteria isolated from urine samples of female
students with suspected UTI.
4. To determine the association
between the isolated bacteria species and demographic characteristics of study participants.
Buyers has the right to create
dispute within seven (7) days of purchase for 100% refund request when
you experience issue with the file received.
Dispute can only be created when
you receive a corrupt file, a wrong file or irregularities in the table of
contents and content of the file you received.
ProjectShelve.com shall either
provide the appropriate file within 48hrs or
send refund excluding your bank transaction charges. Term and
Conditions are applied.
Buyers are expected to confirm
that the material you are paying for is available on our website
ProjectShelve.com and you have selected the right material, you have also gone
through the preliminary pages and it interests you before payment. DO NOT MAKE
BANK PAYMENT IF YOUR TOPIC IS NOT ON THE WEBSITE.
In case of payment for a
material not available on ProjectShelve.com, the management of
ProjectShelve.com has the right to keep your money until you send a topic that
is available on our website within 48 hours.
You cannot change topic after
receiving material of the topic you ordered and paid for.
Login To Comment