RESEARCH PAPER
Antibiotic suceptibility of Escherichia coli isolated in cases of urinary tract infection in Nsukka, Nigeria
1
University of Nigeria, Nsukka, Nigeria
J Pre Clin Clin Res. 2020;14(1):1-7
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
The study was carried out to determine the occurrence and antibiotics susceptibility profile of Escherichia coli recovered from patients with urinary tract infection (UTI) in Nsukka, southeastern Nigeria.
Material and methods:
Midstream urine samples were obtained from 266 outpatients. Standardized questionnaires were used to collect relevant information from the subjects. Urine samples were plated on MacConkey and eosin methylene blue agar. E. coli isolates were identified using standardized procedure. Kirby-Bauer disc diffusion method was used to determine the susceptibility of the isolates.
Results:
An overall UTI prevalence of 18.8% with 29 (19.30%) from females and 21 (18.10%) from males was observed. Females and males within the age range of 20–29 and 50–59 had the highest prevalence rate of 23.2% and 15%, respectively. The highest prevalence rate (26%) occurred in the Igbo-Etiti local government area, compared to the other four local government areas within the study locations. Urinalysis showed that 16 urine samples contained protein, 29 were nitrite positive and 31 were acidic. Most of the isolates were susceptible to nitrofurantoin (94%), ciprofloxacin (70%) and ofloxacin (78%) while all of them were completely resistant to cefuroxime, ceftazidime and augmentin (100%). All 50 (100%) E. coli isolates showed multiple resistance to three or more antibiotics with a resistance index ranging from 0.375–1.00. The MIC results showed that 17 (34%) isolates were sensitive to gentamicin (MIC ≤ 0.25μg/ml, MBC ≥ 128μg/ml), resistant to ciprofloxacin and ofloxacin.
Conclusions:
E. coli is predominantly associated with UTI in the study area and was susceptible to nitrofurantoin.
The study was carried out to determine the occurrence and antibiotics susceptibility profile of Escherichia coli recovered from patients with urinary tract infection (UTI) in Nsukka, southeastern Nigeria.
Material and methods:
Midstream urine samples were obtained from 266 outpatients. Standardized questionnaires were used to collect relevant information from the subjects. Urine samples were plated on MacConkey and eosin methylene blue agar. E. coli isolates were identified using standardized procedure. Kirby-Bauer disc diffusion method was used to determine the susceptibility of the isolates.
Results:
An overall UTI prevalence of 18.8% with 29 (19.30%) from females and 21 (18.10%) from males was observed. Females and males within the age range of 20–29 and 50–59 had the highest prevalence rate of 23.2% and 15%, respectively. The highest prevalence rate (26%) occurred in the Igbo-Etiti local government area, compared to the other four local government areas within the study locations. Urinalysis showed that 16 urine samples contained protein, 29 were nitrite positive and 31 were acidic. Most of the isolates were susceptible to nitrofurantoin (94%), ciprofloxacin (70%) and ofloxacin (78%) while all of them were completely resistant to cefuroxime, ceftazidime and augmentin (100%). All 50 (100%) E. coli isolates showed multiple resistance to three or more antibiotics with a resistance index ranging from 0.375–1.00. The MIC results showed that 17 (34%) isolates were sensitive to gentamicin (MIC ≤ 0.25μg/ml, MBC ≥ 128μg/ml), resistant to ciprofloxacin and ofloxacin.
Conclusions:
E. coli is predominantly associated with UTI in the study area and was susceptible to nitrofurantoin.
REFERENCES (46)
1.
Dibua UME, Onyemerela IS, Nweze EI. Frequency, urinalysis and susceptibility profile of pathogens causing urinary tract infections in Enugu State, Southeast Nigeria. Rev Inst Med Trop Sao Paulo. 2014; 56(1): 55–59. https://doi.org/10.159 /S0036-46652014000100008.
2.
Eticha T. Prevalence and predictors of self-medication with antibiotics among Adi-haqi Campus students of Mekelle University, Ethiopia. IJPSR. 2014; 5: 678–84.
3.
Hooton TM. Uncomplicated urinary tract infection. N Engl J Med. 2012; 366: 1028–1037. https://doi.org/10.105 /NEJMcp1104429.
4.
Martin O, Adamu AA, Julius T, Josephat NM, Eddie W, Charles DK, et al. Prevalence of Bacterial Urinary Tract Infections and Associated Factors among Patients Attending Hospitals in Bushenyi District, Uganda. Int J Microbiol. 2019; 8 pages. https://doi.org/10.1155/2019/4....
5.
Omigie O, Okoror L, Umolu P, Ikuuh G. Increasing resistance to quinolones: A four-year prospective study of urinary infection pathogens. Int J Gen Med. 2009; 2: 171–175. https://doi.org/10.2147/ ijgm.s2641.
6.
Kebira AN, Ochola P, Khamadi SA. Isolation and antimicrobial susceptibility testing of Escherichia coli causing urinary tract infections. J Appl Biosci. 2009; 22: 1320–1325.
7.
Agarwal J, Srivastava S, Singh M. Pathogenomics of uropathogenic Escherichia coli. Indian J Med Microbiol. 2012; 30(2): 141–9. https:// doi.org/10.4103/0255-0857.96657.
8.
Habte TM, Dube S, Ismail N, Hoosen AA. Hospital and community isolates of uropathogens at a tertiary hospital in South Africa. S Afr Med J. 2009; 99: 584–587.
9.
Abubakar EM. Antimicrobial susceptibility pattern of pathogenic bacteria causing urinary tract infections at the specialist hospital, Yola, Adamawa State, Nigeria. J Clin Med Res. 2009; 1(1): 001–008.
10.
Sibanarayan R, Rabindra N, Padhy. Surveillance of acute community acquired urinary tract bacterial infections. J Acute Dis. 2015; 4(3): 186–195. https://doi.org/10.1016/j.joad....
11.
Cheesebrough M. District laboratory practice in tropical countries. Part 2. Cambridge University Press City. 2010; p357.
12.
Bauer AW, Kirby WMM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Patho. 1966; 36: 493–496. https://doi.org/10.1093/ajcp/4....
13.
Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; twenty-third informational supplement. CLSI document M100-S23. CLSI, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087, USA; 2013.
14.
Akinjogunla OJ, Enabulele IO. Virulence factors, plasmid profiling and curing analysis of multi-drug resistant Staphylococcus aureus and Coagulase negative Staphylococcus spp isolated from patients with acute otitis media. J Am Sci. 2010; 6(11): 1022–1033.
15.
Syed SA, Ali S, Abdulaziz AA, Ibrahim HB, Badr NA. Uropathogens and their antimicrobial resistance patterns: Relationship with urinary tract infections. Int J Health Sci. 2019; 13: 48–55.
16.
Gebremariam G, Legese H, Woldu Y, Araya T, Hagos K, GebreyesusWasihun A. Bacteriological profile, risk factors and antimicrobial susceptibility patterns of symptomatic urinary tract infection among students of Mekelle University, northern Ethiopia. BMC Infectious Diseases. 2019; 19: 950. https://doi.org/10.1186/s12879- 019-4610-2.
17.
Kabew G, Abebe T, Miheret A. A retrospective study on prevalence and antimicrobial susceptibility patterns of bacterial isolates from urinary tract infections in Tikur Anbessa specialized teaching hospital Addis Ababa, Ethiopia. Ethiop J Health Dev. 2013; 27(2): 111–117.
18.
Ngwa YB, Iliyasu H, Young E, Owuna G. Bacteriuria and antimicrobial susceptibility of Escherichia coli isolated from urine of asymptomatic university students in Keffi, Nigeria. Jundishapur J Microbiol. 2012; 5(1): 323–7.
19.
Ayoade F, Moro DD, Ebene OL. Prevalence and antimicrobial susceptibility pattern of asymptomatic urinary tract infections of bacterial and parasitic origins among university students in redemption camp, Ogun State, Nigeria. OJMM. 2013; 3: 219–26. http://dx.doi. org/10.4236/ojmm.2013.34033.
20.
Sharma E, Thakuriya R, Kumar HG. Study of predictors of urinary tract infections in nursing. IJRTSAT. 2015; 15(3): 442–3.
21.
Nsofor CA, Obijuru CE, Ozokwor CL. Asymptomatic bacteriuria among female students of a tertiary institution in southeast Nigeria. ECBVR. 2016: 4(2): 106–112.
22.
Wogu MD, Ogbebor NE. Prevalence of asymptomatic bacteriuria in secondary school students in Benin City. AFRREV. 2011; 5(4): 145–151.
23.
Helen OO, Ossai OS. Asymptomatic bacteriuria among secondary school students in Benin City, Nigeria. JPHE. 2013; 5(2): 66–9.
24.
Kolawole AS, Kolawole OM, Kandaki-Olukemi YT, Babatunde SK, Durowade KA, Kolawole CF. Prevalence of urinary tract infection patients attending DalhatuAraf Specialist Hospital, Lafia, Nassarawa State, Nigeria. Int J Med Sci. 2009; 1(5): 163–167. https:// doi.org/10.5897/IJMMS.
25.
Alo MN, Saidu AY, Ugah UI, Alhassan M. Prevalence and antbiogram of bacterial isolates causing urinary tract infections at Federal Teaching Hospital Abakaliki I (FETHA I). BMRJ. 2015; 8(2): 403–417. https://doi. org/10.9734/BMRJ/2015/16696.
26.
Obiogbolu CH, Okonko IO, Anyamere CO, Adedeji AO, Akanbi AO, Ogun AA, et al. Incidence of urinary tract infections (UTIs) among pregnant women in Awka metropolis, Southeastern Nigeria. SRE. 2009; 4(8): 820–824.
27.
Aiyegoro OA, Igbinosa OO, Ogunmwonyi IN, Odjadjare EE, Igbinosa OE, Okoh AI. Incidence of urinary tract infection (UTI) among children and adolescents of Ile-Ife Nigeria. Afr J Microbiol Res. 2007; 1: 13–9.
28.
Wei CT, Piotr MC. Urinary tract infections in adults. Singap Med J. 2016; 57(9): 485–90. https://dx.doi./10.11622%2Fsme....
29.
Alkhyat SH, Maqtari MAA. Prevalence of microorganisms isolates from urinary tract infections at some hospitals in Sana’a City, Yemen. Int J Curr Microbiol App Sci. 2014; 3(6): 876–885.
30.
Nicolle LE. Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis. Urol Clin North Am. 2008; 35(1): 1–12. https://doi.org/10.1016/j.ucl.....
31.
Arul KC, Dileesh KG, Kumar MA. Cross sectional study on the distribution of urinary tract infection and their antibiotic utilization pattern in Kerala. International Journal of Pharm Tech Research. 2012; 3 (3): 1125–1130.
32.
Onoh RC, Umeora OUJ, Egwuatu VE, Ezeonu PO, Onoh TPJ. Antibiotic sensitivity pattern of uropathogens from pregnant women with urinary tract infection in Abakaliki, Nigeria. Infect Drug Resist. 2013; 6: 225– 233. https://doi.org/10.2147/IDR.S4....
33.
Demilie T, Beyene G, Melaku S, Tsegaye D. Urinary bacterial profile and antibiotic susceptibility pattern among pregnant women in North West Ethiopia. Ethiop J Health Sci. 2012; 2(2): 121–128.
34.
Oladeinde BH, Omoregie R, Olley M, Anunibe JA. Urinary tract infection in a rural community of Nigeria. N Am J Med Sci. 2011; 3(2):75–77. https://dx.doi.org/10.4297%2Fn....
35.
Emiru T, Beyene G, Tsegaye W, Melaku S. Associated risk factors of urinary tract infection among pregnant women at FelegeHiwot Referral Hospital, Bahir Dar, North West Ethiopia. BMC Res Notes. 2013; 6: 292. https://doi.org/10.1186/1756-0....
36.
Chukwu OS, Ezeonu IM, Agah VM, Alo MN, Ugah UI. Bacteriuria in pregnant women in Nsukka Urban, Enugu State, Nigeria. W J Life Sci Med Res. 2014; 3(3): 94–100.
37.
Ganesh R, Shrestha D, Bhattachan B, Rai G. Epidemiology of urinary tract infection and antimicrobial resistance in a pediatric hospital in Nepal. BMC Infect Dis. 2019; 19: 420. https://doi.org/10.1186/s12879- 019-3997-0.
38.
Aboderin OA, Abdu AR, Odetoyin BW, Lamikanra A. Antimicrobial resistance in Escherichia coli strains from urinary tract infections. J Natl Med Assoc. 2009; 101: 1268–1273. https://doi.org/10.1016/s0027-....
39.
Rabasa AI, Gofama MM. Urinary tract infection in febrile children in Maiduguri North Eastern Nigeria. Niger J Clin Pract. 2009; 12: 124–7.
40.
Poonam US, Ulka B. Isolation and identification of bacteria causing urinary tract infections in pregnant women in Vidarbha and their drug susceptibility patterns in them. Int J Curr Microbiol App Sci. 2013; 2(4): 97–103.
41.
Olayinka BO, Olonitola OS, Olayinka AT, Agada EA. Antibiotic susceptibility pattern and multiple antibiotic resistance index of Pseudomonas aeruginosa urine isolates from a University Teaching Hospital. Afr J Clin Exper Microbiol. 2004; 5(2): 198–202. http://dx.doi.org/10.4314/ajce....
42.
Gillespie SH, Bamford KB. Resistance to antibacterial agents. In Medical Microbiology and Infection at a Glance. 4th ed. UK: Wiley-Blackwell; 2012. p. 20–2.
43.
Alabi OS, Onyenwe NE, Satoye KA, Adeleke OE. Prevalence of extended spectrum β-lactamase producing isolates from asymptomatic bacteriuria among students in a tertiary institution in Ibadan, Nigeria. J Nat Sci. 2014; 12(4): 111–4.
44.
Jharna MN, Srinivas AD, Buddhapriya, Subhash CP. Antibiotic resistance pattern among common bacterial uropathogens with a special reference to ciprofloxacin resistant Escherichia coli. Indian J Med Res. 2012; 136:842–849.
45.
Zervos MJ, Hershberger E, Nicolau DP, Ritchie DJ, Blackner LK, Coyle EA. Relationship between fluoroquinolone use and changes in susceptibility to fluoroquinolones of selected pathogens in 10 United States teaching hospitals, 1991–2000. Clin Infect Dis. 2003; 37: 1643–8. https://doi.org/10.1086/379709.
46.
Kahlmeter G. Prevalence and antimicrobial susceptibility of pathogens in uncomplicated cystitis in Europe. Int J Antimicrob Agents. 2003; 2: 49–52. https://doi.org/10.1016/s0924–....
Share
RELATED ARTICLE
| eISSN: | 1898-7516 |
| ISSN: | 1898-2395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
