The etiology and antimicrobial susceptibility patterns of urinary tract infections at a private Nigerian teaching hospital in South West Nigeria

Abstract

Background: Urinary tract infections (UTI’s) are among the commonest bacterial infectious disease in clinical practice with a wide range of etiologic agents. It frequently occurs in both the hospital and the community.

Aims/Objectives: To determine the etiology of UTI at BUTH and obtain data on their susceptibility and resistance patterns.

Methods: This was a prospective analysis of data on patients with UTI obtained from in and outpatients over a six month period. Samples had been obtained by clean catch mid-stream urine or suprapubic aspiration. The organisms had been
identified by biochemical methods with susceptibility and resistance testing performed. Data analysis was with EPI-INFO version 3.5.1

Results: There were a total of 200 urine samples that had positive growth. Prevalent organisms were Escherichia coli (48%) and Klebsiella spp (24%), followed by Staphylococcus aureus (10%) and Coagulase Negative Staphylococci (6.5%). The risk factors for UTI were female gender (p = 0.00), Diabetes mellitus (p = 0.03) and genitourinary surgery (p = 0.04). Effective antibiotics in-vitro to Escherichia coli were Nitrofurantoin and Cefepime at 84.8% and 92.3% respectively; while Cotrimoxazole performed poorly (32.5% susceptibility).

Conclusion: Urinary tract infections are an important cause of morbidity in our environment and inaccuracies in diagnosis will prolong morbidity and may lead to costly and unsafe treatments.The prevalent pathogens in our environment are the Gram negative bacilli, Escherichia coli and Klebsiella pneumoneae. Nitrofurantoin retains efficacy to both urinary pathogens.

Keywords: Urinary Tract Infection, Catheterization, Escherichia coli, Risk factors, Nitrofurantoin