Urinary Tract Infections Caused by Enteric Bacteria and Antibiotic Sensitivity among Symptomatic Males Visiting Special Treatment Center, Nairobi City County, Kenya
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Date
2020-10
Authors
Ondari, Dinah Moraa
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Urinary tract infections are not as common in men as they are in women. However,
when present, they are considered to be indicative of serious urological abnormalities
and thus considered to be complicated infection in men. They can either be typical or
atypical. Typical irritative lower urinary tract infection can be presented by most men
with clinical symptoms such as frequency or urgency in micturition, nocturia, dysuria,
and hematuria. The less common atypical urinary tract infection presents with clinical
symptoms such as confusion, urine incontinence and is highly associated with elderly
men. Due to the stigma and denial associated with urinary tract infections, male patients
with urinary tract infections self-diagnose and use over the counter antibiotics leading
to the mismanagement of disease and increase in antibiotics resistance. The study aimed
at investigating the prevalence of urinary tract infections caused by enteric bacteria and
antibiotic sensitivity among symptomatic male patients visiting special treatment
center, in Nairobi, Kenya. A cross-sectional study was carried out among three hundred
and eighty-four (384) male patients attending the special treatment center. The male
participants were selected using systematic random sampling technique. Aseptic
procedure of urine collection was explained to the patient and 10-15ml mid-stream
urine sample collected. Urinalysis using dipstick was done, followed by culture on
CLED and blood Agar. Kirby Bauer disc diffusion technique for antibiotic sensitivity
was done using Ofloxacin, cefaclor, nitrofurantoin, Nalidixic acid, Augmentin,
cefuroxime, minocycline, ciprofloxacin and gentamicin. Data was cleaned, coded and
entered into the computer and analyzed using Statistical Package for Social Science
software version 23. Both descriptive and inferential statistical test techniques were
used and the output presented using tables and charts. The prevalence was 65.6%
calculated based on the proportion of participants with UTI during the study period.
The Gram negative bacteria isolated were: Escherichia coli, Klebsiella pneumonia,
Proteus mirabilis and Pseudomonas aeruginosa while Gram positive were
Staphylococcus aureus and Staphylococcus saprophyticus. The most frequent bacteria
isolated was Escherichia coli (42%) and the least was P. aeuruginosa (4.7%). The
occurrence of urinary tract infections was noted to be most common between the ages
of 20-29 years. There was moderate relationship between P. mirabilis, S. saprophyticus
and age (r= 0.698, r=0.85). There was also a slight statistical significance between age
and S. aureus (p=0.046). The most effective antibiotic to all bacteria was ofloxacin and
the isolates exhibited resistance to nitrofurantoin, augmentin and nitrofurantoin.
Sensitivity of P. mirabilis was 100% to cefaclor while P. aeruginosa was 100%
resistance to all the drugs. All isolates demonstrated multidrug resistance to more than
two drugs. The study therefore recommends a regular surveillance and research of
antibiotic use in the management of UTI to avoid multidrug resistance which would
otherwise impact on the increasing cost of care.
Description
A Thesis Submitted In Fulfillment for the Award of Degree of Master of Science in Infectious Diseases
(Bacteriology) in the School of Medicine, Kenyatta University. October, 2020
Keywords
Urinary Tract Infections, Enteric Bacteria, Antibiotic Sensitivity, Symptomatic Males, Special Treatment Center, Nairobi City County, Kenya