Isolation of Uropathogenic Bacteria and their Antimicrobial Susceptibility Pattern in Urine Samples of Patients with Suspected Urinary Tract Infection in Eastern Regional Hospital, Koforidua

Abstract

Background: Urinary tract infection (UTI) is a common bacterial infection known to affect the different parts of the urinary tract and the occurrence is found in both females and males. Distribution and susceptibility of UTI-aetiologic agents change according to time and place. To ensure appropriate treatment, knowledge of these aetiologic agents and their antibiotic susceptibility pattern is mandatory. However, the extensive use of antimicrobial agents have invariably resulted in the development of antibiotic resistance, which, in recent years, has become a major problem worldwide. Objective: The main objective of this study was to determine the prevalence and antibiotic susceptibility pattern of Uropathogenic bacteria in urine samples of patients with suspected UTI at the Eastern Regional Hospital, Koforidua - Ghana. Study design: A cross sectional study was conducted among patients who attend Eastern Regional Hospital, Koforidua from December 2015 to March 2016. Methods: Four hundred and twenty-two study participants with suspected UTI and those admitted in the wards with signs and symptoms of UTI were enrolled. Anyone aged one (1) day and above without being on antibiotic therapy, in labour, or delivered within 48 hours, and not from outside Eastern Region as pointed out by the attending clinician, was conveniently enrolled. Socio-demographic data were extracted from patients’ cards and/or from the Health Administrative Management System (HAMS). Organisms were identified and antibiotic susceptibility was performed on all the bacterial isolates using Kirby-Bauer’s disc diffusion method. Zones of inhibition were measured with caliper

after 18 to 24 hours of incubation. Measured zone inhibitions were compared with zone diameter interpretative chart. Results: A total of 22.5% (95/422) uropathogens were isolated from the study subjects attending the Eastern Regional Hospital, Koforidua. The bacterial isolates included E. coli 37.89%, Klebseilla spp., 34.74%, Pseudomonas aeruginosa 2.11%, Staphylococcus aureus 2.11% and Citrobacter spp., 2.11%. The majority of isolates, 78.95% (75/95), were from females in whom the highest percentage of isolates (100%) was seen in the age group 31 to 40 years whiles for males it was seen in age group 0 to 10 years (44.44%). All the bacteria showed high sensitivity to Amikacin and Nitrofurantoin. They showed resistance to Augmentin, Ampicillin, Co-trimoxazole and Gentamycin. Conclusion: This study shows that Escherichia coli is the main organism causing UTI in this catchment area. In addition, the study illustrates that females are more susceptible to UTI than males. Furthermore, the study demonstrated resistance of the isolates to Augmentin, Ampicillin, Tetracycline and Co-trimoxazole, and sensitive to Amikacin and Nitrofurantoin. This demonstrates that Amikacin and Nitrofurantoin are clear alternative first line drugs against UTI causing organisms as clinicians await culture and sensitivity results from the laboratory.