Characterization and antibiotic resistance patterns of bacteria associated with urinary tract infections among patients having benign prostatic hyperplasia (BPH) in a tertiary hospital in Enugu

Abstract

Urinary tract infection (UTI) is a common microbial infection in patients having benign prostatic hyperplasia(BPH). BPH usually necessitates catheterization due to bladder outlet obstruction (BOO), posing a risk of catheter-associatedurinary tract infection (CA-UTI). Treatment of UTIs has become increasingly complex due to the rising prevalence of drug resistance among uropathogens. The aim of the study was to isolate and characterize bacteria associated with UTI from urine of patients having BPH and determine the antibiotic resistance patterns of the isolates. One hundred and seventeen urine samples were collected aseptically from male patients having BOO due to BPH, and are attending urology clinic at Enugu State University of Science and Technology Teaching Hospital (ESUTTH), Parklane Enugu. Bacteria were isolated from the urine samples using appropriate microbiological and biochemical techniques. Colony count was used to determine UTI (bacterial growth ≥ 10 4 CFU/ml of a single bacteria species). Antibiotic sensitivity testing of isolates was doneusing Kirby Bauer disc diffusion method. Out of the 117 urine samples collected, 47 (40.2%) had urinary tract infection. The bacteriamostly isolated were Gram-negative, including Escherichia coli 19 (40.4%), Klebsiella pneumoniae 10 (21.3%), Pseudomonas aeruginosa 6 (12.8%), Proteus mirabilis 2 (4.3%), and Gram-positive bacteria, including Staphylococcus aureus 5 (10.6%), Enterococcus spp. 3 (6.4%) and Coagulase-negative Staphylococcus 2 (4.3%). The antibiotic mostly resisted was ampicillin (95.7%), while the least resistance was observed for levofloxacin (25.5%) and nitrofurantoin(27.7%). Urinary tract infection was more prevalent among the age group 60-69 years (44.7%). This study, while recommending the use of nitrofurantoin and levofloxacin for the treatment of UTIs among patients with BPH, disapproves ampicillin as a suitable empiric treatment option.