Browsing by Author "Asafo-Adjei, K."
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Item Antimicrobial Resistance Patterns of Uropathogens Associated With Bacteriuria among Patients Presenting With Bladder Outlet Obstruction at the Korle-Bu Teaching Hospital, Accra(University Of Ghana, 2017-07) Asafo-Adjei, K.Background: Bladder outlet obstruction (BOO) is an important public health problem which affects the health and social wellbeing of mainly elderly men. Bladder outlet obstruction is a major risk factor for the development of bacteriuria and recurrent urinary tract infections. These infections are usually associated with multi-drug resistant uropathogens leading to significant morbidity and mortality. Successful empirical management of these infections is dependent on knowledge of antimicrobial susceptibility patterns of the causative agents. However, in Ghana little is known about the bacterial etiology among BOO patients and their antibiogram. Aim: To investigate antibiotic resistance of uropathogens associated with bacteriuria among patients with BOO at the Korle-Bu Teaching Hospital. Methodology: This was a cross-sectional study involving 188 study male patients presenting with bladder outlet obstruction at the Urology Unit, Korle-Bu Teaching Hospital (KBTH). Urine specimens were collected from study recruits for bacterial culture and identification. Antimicrobial susceptibility testing was carried out on the bacterial isolates using Kirby Bauer method. Demographic and clinical information were also collected from all the study participants. The data were analyzed with Graph Pad Prism version 6. RESULTS: The overall prevalence of bacteriuria among BOO patients was 76.6%. The risk factors of bacteriuria found among the BOO patients included catheterization (p < 0.0001), pyuria (p < 0.0001) and haematuria (p < 0.0005). Nineteen bacterial isolates covering ten genera were identified in the urine specimens. Escherichia coli was the most common bacteria isolated (33.3%) followed by Klebsiella species (11.5%). Bacterial isolates were most resistant to augmentin (97.8%) followed by tetracycline (85.8%), nalidixic acid (82.8%) and ciprofloxacin (75%) whiles 93.6% were multi-drug resistant. The highest susceptibility was observed with amikacin (4.4% resistance). Forty six percent prevalence of extended-spectrum beta-lactamases was observed among selected enterobateriaceae isolates. Conclusion: The prevalence of bacteriuria at KBTH Is high (76.6%) among BOO patients. Escherichia coli is the main cause of bacteriuria among these patients and the urinary tract infections could be managed with nitrofurantoin and amikacin. Ciprofloxacin which was the most commonly prescribed antibiotic for the BOO patients was less effective. The findings of this study further strengthen the need for a re-evaluation of the recommended antibiotics used in therapeutic management of urinary tract infection in Ghana especially among bladder outlet obstruction patients.Item Urinary Tract Infections among Bladder Outlet Obstruction Patients in Accra, Ghana: Aetiology, Antibiotic Resistance, and Risk Factors(Diseases, 2018) Asafo-Adjei, K.; Mensah, J.E.; Appiah-Korang, L.; et al.The aim of this study was to investigate urinary tract infections among patients with Bladder Outlet Obstruction (BOO) at the Korle Bu Teaching Hospital (KBTH) in Accra, Ghana, including the prevalence, risk factors, aetiological agents and their antibiogram. Urine specimens were collected from 188 male patients presenting with BOO and cultured for bacteria. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antimicrobial agents using the Kirby Bauer method. Demographic information and the clinical history of study participants were also recorded. The prevalence of urinary tract infection among the BOO patients was 76.6% and the main risk factor identified was catheterization (p < 0.0001). A wide range of bacterial organisms was isolated from urine specimens and they were predominantly, Enterobacteriaceae; Escherichia coli was the most frequent cause of bacteriuria (33.3%), followed by Klebsiella (17.3%). Bacterial isolates were most resistant to Augmentin (97.8%) followed by tetracycline (85.8%), nalidixic acid (82.8%) and ciprofloxacin (75%) while 93.6% were multi-drug resistant. The highest susceptibility was observed with amikacin, which had a resistance prevalence of 4.4% resistance. These findings have important implications in the treatment of urinary tract infections among the BOO patients in Ghana.