Prevalence of Bacteriuria and Antibiotic Sensitivity Profile of Bacterial Isolates among Sexually Active Nonpregnant Women Attending Thika Level 5 Hospital
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Date
2019-06
Authors
Musili, Purity
Journal Title
Journal ISSN
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Publisher
Kenyatta University
Abstract
Bacteriuria is commonly found in women and about thirty three percent (33%) of adult
women have encountered an incidence of symptomatic cystitis at least once in their life
time. In case the uropathogens are unidentified and management undertaken, bacteriuria
may cause more dangerous and adversed complications, including nephritis and renal
failure. Majority of studies done in Kenya have focused on pregnant women with no
documented information available on the sexually active non pregnant women population
despite a heightened risk of bacteriuria in this age group. The objectives of this study
were to determine the occurrence of bacteriuria, to isolate bacterial pathogens associated
with the bacteriuria, to determine antibiotic susceptibility profile on the isolated bacterial
pathogens in sexually active non pregnant women attending Thika level 5 Hospital,
Kiambu County, Kenya. The study employed a cross sectional design and random
sampling technique. Three hundred and eighty four (384) mid-stream urine samples were
collected from sexually active non pregnant women aged 18 to 48years attending Thika
level 5 hospital. The urine samples were analyzed using biochemical methods.
Microscopy was done to observe the presence of motile bacteria and pus cells. The
positive samples were cultured on Cystine Lactose Electrolyte Deficient (CLED) media.
The isolated bacterial pathogens were identified by standard bacteriological methods.
Antibiotic susceptibility testing was done on the antibiotics recommended for bacteriuria
by the Ministry of Health. Demographic characteristics were analyzed using simple
percentages among related variables and presented using pie chart and tables. The
occurrence of bacteriuria was calculated using the formulae of Le and Boen et al. (1995).
The bacterial isolates and antibiotic susceptibility tests were analyzed using Pearson's
Chi-square test at a confidence interval of 95%. Out of 384 urine samples tested,
311(81%) samples had significant growth (P=0.001) and 73(19%) had no growth
(P=0.056). The frequency of the study population was high within age group 18-27 years
with (46.88%).The distribution of bacteriuria within age groups was highest in age group
18-27 years with (45.31%, P= 0.001). This study showed decrease of bacteriuria with
increasing age (P=0.001). Escherichia coli was the most isolated bacterial pathogen
(41.5%). Escherichia coli and Staphylococcus saprophyticus pathogens were isolated in
all age groups. Among the ten antibiotics tested, bacterial isolates were sensitive to
Cefuroxime at 93.2% (χ2=29.809, P=0.001) and resistant to ceftazidime at 89.7%
(χ2=62.791, P=0.001). The most sensitive bacterial isolate was P. mirabilis and the most
resistant was P. aeruginosa. This study recommended that, since antibiotic resistance
among the uropathogens is evolving problem, a routine surveillance to monitor the
etiologic agents of bacteriuria and the resistance pattern should be carried out timely to
choose the most effective empirical treatment by the physicians. Data obtained from this
study is important in appropriate management and treatment of bacteriuria. This will help
in proper prescription of the appropriate antibiotic for the treatment of bacteriuria.
Description
A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science (Infectious Diseases) In the School of Medicine of Kenyatta University. June, 2019