Volume 8, Issue 3, May 2019, Page: 21-27
Correlating Urinary Tract Infection with Patients’ Presenting Symptoms and Bacterial Isolation from Urine in Uyo, Nigeria
Onwuezobe Ifeanyi Abraham, Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, University of Uyo, Uyo, Nigeria
Ubong Etang Ekerenam, Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, University of Uyo, Uyo, Nigeria
Ekuma Agantem Emmanuel, Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, University of Uyo, Uyo, Nigeria
Received: Jun. 14, 2019;       Accepted: Jul. 17, 2019;       Published: Jul. 30, 2019
DOI: 10.11648/j.sjcm.20190803.11      View  33      Downloads  8
Abstract
Background: In clinical practice, diagnosis of urinary tract infection (UTI) ideally involves the presence of symptoms and a positive urine culture results. However, due to lack of laboratory facility and where present, delays in getting laboratory result encountered by attending out-patient Physicians, diagnosis are made from presenting symptoms in patients. Empirical treatments are commenced with expectation of positive outcome. Objectives: The aim of this study was to correlate Urinary tract infection with presenting symptoms in patients and laboratory culture results from mid-stream urine samples in Uyo, Nigeria. Materials and Methods: This six months descriptive cross sectional study was carried out in the outpatient Department of the University of Uyo Teaching Hospital in Uyo. Data was obtained through questionnaire administered on 370 consenting outpatients and laboratory culture results from collected midstream urine were analyzed using SPSS software (version 20.0). The predisposing risk factors in these patient were also assessed. The midstream urine samples from the subjects were standardly processed. Cultured urine samples that yielded Gram negative uropathogens were further identified using Microbact 24E (Oxoid, UK), while those that yielded Gram positive uropathogens were identified by the appropriate standard procedures. Results: The presenting symptoms were; discomfort when urinating, urge incontinence (7.6%), frequent urination (11.9%), and cloudy urine with foul smell (8.1%), malaise (23.8%), fever (23.5%), back/flank pain (3.8%) and hematuria (4.6%) (P<0.001). The attendant risks factors assessed were age, gender, cleaning method after urination/defecation, contraceptive use, diabetes, past history of UTI and recent catheter use (P<0.05). Female outpatients had more laboratory confirmed UTI (25.9%) than male outpatients (11.5%). Also revealed is the fact that there is higher prevalence of UTI in female outpatients within the reproductive age group of 28-37 years (43.8%). Conclusion: In this study, less than 30% of female patients with presenting symptoms of UTI had positive urine culture test result while only about 12% of males with these symptoms are culture positive for UTI in Uyo, Akwa Ibom State, Nigeria.
Keywords
Urinary Tract Infection, Presenting Symptoms, Culture Test Result, Uyo, Nigeria
To cite this article
Onwuezobe Ifeanyi Abraham, Ubong Etang Ekerenam, Ekuma Agantem Emmanuel, Correlating Urinary Tract Infection with Patients’ Presenting Symptoms and Bacterial Isolation from Urine in Uyo, Nigeria, Science Journal of Clinical Medicine. Vol. 8, No. 3, 2019, pp. 21-27. doi: 10.11648/j.sjcm.20190803.11
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
P. Suwangool (2012). Current Management of Urinary Tract Infections. Bangkok Medical Journal, 3, 101-106.
[2]
P. Anuja and M. D. Shah (2015). Overview of Urinary Tract Symptoms. Merck Manual: Kenilworth, USA.
[3]
C. M. Gonzalez and A. J. Schaeffer (1999). Treatment of Urinary Tract Infection: what’s old, what’s new and what works. World Journal of Urology, 17 (6):372-382.
[4]
M. J. Lucas and F. G. Cunningham (1993). Urinary Tract Infections in Pregnancy. Clinical Obstetrics and Gynaecology, 36 (4): 855-868.
[5]
S. M. Ahmed and A. K. Avazara (2008). Urinary Tract Infections (UTI) Among Adolescent Girls in Karimnagar District. Indian Journal of Medicine, 39, 12‑15.
[6]
L. B. Travis And B. H. Bruhard (1991). Infections of the Urinary Tract. In: Rudolph’s Paediatrics, 19th edn. Stamford, Appleton and Lange, p. 237.
[7]
R. H. Rubin, T. R. Jr. Beam and W. E. Stamm (1992). An Approach to Evaluating Antibacterial Agents in the Treatment of Urinary Tract Infection. Clinical Infectious Diseases Journal; 14 (supplement 2): S253-254.
[8]
M. Cheesbrough (2010). District Laboratory Practice in Tropical Countries, part 2, New York, USA: Cambridge University Press, pp. 62-118.
[9]
K. Gupta, T. M. Hooton, K. G. Naber, B. Wullt, R. Colgan and L. G. Miller (2011). International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clinical Infectious Diseases, 52 (5): 103-120.
[10]
A. J. Schaeffer, N. Rajan and Q. Cao (2001). Host Pathogenesis in Urinary Tract Infections. International Journal of Antimicrobial Agents, 17 (4):245-251.
[11]
A. L. Flores-Mireles, J. N. Walker, M. Caparon and S. J. Hultgren (2015). Urinary Tract Infections: Epidemiology, Mechanisms of Infection and Treatment Options. Nature Reviews Microbiology, 13, 269-284.
[12]
K. Gupta and B. Trautner (2012). Urinary Tract Infections in the Clinic. Annal of International Medicine, 156 (5): 1-15.
[13]
J. D. Sobel and D. Kaye (2010). Urinary Tract Infections. In: Mandell, Douglas & Bennett’s Principles of Infectious Diseases, G. L. Mandell, J. E. Bennett & R. Dolin, Eds., Churchill Livingstone, Philadelphia, PA: USA, pp. 957-985.
[14]
N. E. Tolkoff and R. H. Rubin (1986). Urinary Tract Infection. Significance and Management. Bulletin of the New York Academy of Medicine, 62 (2): 131-148.
[15]
H. D. Isenberg (2012). Urine Culture. In: Clinical Microbiology Handbook. Pakistan Antimicrobial Resistance Network, pp. 1-31.
[16]
D. Clayson, D. Wild, H. Doll, K. Keating and K. Gondek (2005). Validation of a Patient-administered Questionnaire to Measure the Severity and Bothersomness of Lower Urinary Tract Symptoms in Uncomplicated Urinary Tract Infection (UTI): The UTI Symptom Assessment Questionnaire. British Journal of Urology International; 96, 350-359.
[17]
B. B. Oluremi, A. O. Idowu and J. F. Olaniyi (2011). Antibiotic Susceptibility of Common Bacterial Pathogens in Urinary Tract Infections in a Teaching Hospital in South Western Nigeria. African Journal of Microbiology Research, 5 (22): 3658-3663.
[18]
P. K. C. Arul, K. G. Dileesh and M. Vijayan (2012). A Cross Sectional Study on Distribution of UTI and their Antibiotic Utilisation Pattern in Kerala. International Journal of Research in Pharmaceutical and Biomedical Sciences, 3 (3): 1125-1130.
[19]
K. O. Akinyemi, S. A. Alabi, M. A. Taiwo and E. A. Omonigbehin (1997). Antimicrobial Sussceptibility Pattern and Plasmid Profiles of Pathogenic Bacteria Isolated from Subjects with Urinary Tract Infections in Lagos, Nigeria. Niger Quarterly Journal of Hospital Medicine, 1, 7-11.
[20]
A. S. Kolawole, O. M. Kolawole, Y. T. Kandaki-Olukemi, S. K. Babatunde and K. A. Durowade (2009). Prevalence of Urinary Tract Infections (UTI) among Patients Attending Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria. International Journal of Medicine and Medical Sciences, 1 (5): 163-167.
[21]
E. E. Okonfua and B. N. Okonofua (1989). Incidence and Pattern of Asymptomatic Bacteriuria of Pregnancy in Nigeria Women. Nigerian Medical Practitioner, 17, 354-358.
[22]
R. Raz, Y. Gennesin, J. Wasser, Z. Stoler, S. Rosenfeld, E. Rottensterich and W. E. Stamm (2000). Recurrent urinary tract infections in postmenopausal women. Clin Infect Dis. 30 (1):152-6.
[23]
Foxman, B. (2002). Epidemiology of UTIs: Incidence, Morbidity and Economic Cost. American Journal of Medicine, 113 Supplement 1A, 5S-13S.
[24]
B. Foxman, P. Somsel, P. Tallman, B. Gillespie, R. Raz, and R. Colodner et al. (2001) Urinary tract infection among women aged 40 to 65: behavioral and sexual risk factors. J Clin Epidemiol. 54 (7):710-8.
[25]
Z. Huang, H. Xiao, H. Li, W. Yan and Z. Ji (2017). Analysis of the incidence and risk factors of male urinary tract infection following urodynamic study. Eur J Clin Microbiol Infect Dis. 36 (10):1873-1878.
[26]
H. I. Inabo and H. B. T. Obanibi (2006). Antimicrobial Susceptibility of some Urinary Clinical Isolates to commonly used Antibiotics. African Journal of Biotechnology, 5 (5): 487-489.
[27]
A. O. Kehinde, K. S. Adedapo, C. O. Aimaikhu, A. A. Odukogbe, O. Olayemi and B. Salako (2011). Symptomatic Bacteriuria among Asymptomatic Antenatal Clinic Attendees in Ibadan, Nigeria. Tropical Medicine and Health, 39 (3): 73-76.
[28]
O. A. Aboderin, A. Abdu, B. W. Odetoyinbo and A. Lamikanra (2009). Antimicrobial Resistance in Escherichia coli Strains from Urinary Tract Infections. National Medical Association, 101, 1268-1273.
[29]
F. D. Otajevwo (2012). Urinary Tract Infection among Symptomatic Outpatients Visiting a Tertiary Hospital Based in Mid-Western Nigeria. Global Journal of Health Sciences, 5 (2): 187-199.
[30]
P. R. Murray, F. C. Tenovar, A. P. Michael, E. I. Baron, M. A. Pfaller and R. H. Yolken (1995). Manual of Clinical Microbiology, 6 th ed. American Society for Microbiology, Washington, DC, pp. 231-236.
Browse journals by subject