Frequency, urinllysis and susceptibility profil of pathogens causing urinary ttract infections in enugu state, southeast Nigeria / Perfil da frequencia, analise urinaria e suscetibilidade de patogenos causando infeccoes do trato urinario no estado de Enugu, Sudeste da Nigeria

ABSTRACT

Objective: This study was designed to determine the frequency and causative agent(s) of urinary tract infections (UTIs) in individuals with symptoms of urinary tract infections in Enugu State of Southeast Nigeria, and to determine the antibiotic susceptibility pattern of microbial agents isolated from urine culture. Methods: The study involved 211 individuals (149 females and 62 males) clinically suspected for UTI. Urine samples were collected by the mid-stream ‘clean catch' method and tested using standard procedures. Antibiotic susceptibility of the isolated pathogens was tested using the Kirby-Bauer technique according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Microscopy of centrifuged urine samples showed 16 patients had pyuria while 54 had pus cells. Calcium oxalate crystals were found in 14 samples. Urinalysis performed with urine samples showed 17 had protein; seven were nitrite positive and three had moderate to high glucose concentration. Fifty-four urine samples (36.2%) from females and 12 (19.4%) from males showed significant growth upon culture. Gram stain and biochemical tests identified nine different organisms with Escherichia coli as the most common isolated species. Forty three randomly selected strains were further tested for their susceptibility against a panel of antibiotics. Thirty isolates (81.08%) were resistant to four or more antibiotics with the highest resistance shown by E. coli (76.67%). All the Gram- negative isolates were resistant to Ampicilox, Cefuroxime and Amoxicillin. Conclusion: Urinary tract infections were found more in females in the area under study. As found in other studies, E. coli was the most predominant isolate, although other organisms seem to be on the increase.

RESUMO

Objetivo: O estudo teve como objetivo determinar a frequência e agentes causadores das infecções do trato urinário (UTIs) em indivíduos com sintomas desta infecção no estado de Enugu, Sudeste da Nigéria e determinar a suscetibilidade antibiótica dos agentes microbianos isolados de cultura da urina. Métodos: O estudo envolveu 211 indivíduos (149 mulheres e 62 homens) clinicamente suspeitos para UTI. Amostras urinárias foram coletadas pelo método de meia corrente “clean catch” e testados por procedimentos standards. Suscetibilidade aos antibióticos dos patógenos isolados foi testada usando a técnica de Kirby-Bauer e de acordo com as diretrizes do “Clinical and Laboratory Standards Institute” (CLSI). Resultados: Microscopia das amostras de urina centrifugadas mostraram que 16 pacientes tinham piúria enquanto que 54 tinham células do pus. Cristais de oxalato de cálcio foram encontrados em 14 amostras. Análise de amostras da urina mostraram que 17 tinham proteína; sete eram positivas para nitrito e três tinham concentração de glicose de moderada para alta. Cinquenta e quatro amostras de urina (36.2% de mulheres) e 12 (19.45% de homens) mostraram crescimento significante após cultura. Coloração pelo Gram e testes bioquímicos identificaram nove organismos diferentes com a Escherichia coli sendo a mais comum das espécies isoladas. Quarenta e três espécies selecionadas ao acaso foram testadas posteriormente para sua suscetibilidade contra um painel de antibióticos. Trinta amostras isoladas (81.08%) foram resistentes a quatro ou mais antibióticos sendo que a maior resistência foi da E. coli (76.67%). Todas as amostras Gram negativas isoladas foram resistentes a Ampicilox, Cefuroxime e Amoxicilina.