Abstract
Asymptomatic bacteriuria (ASB) is benign except in certain medical conditions such as pregnancy and immunosuppression. In Ghana, there are hardly any studies on urinary infections among sickle cell disease (SCD) patients, and the few studies carried out in Africa focused on pediatric SCD populations. The current study aimed to investigate the risk of ASB among SCD patients at a tertiary hospital in Ghana. This was a cross-sectional study involving 110 SCD patients and 110 age and sex matched healthy controls. Urine specimens were collected from all the study subjects and analyzed by standard microbiological methods. Demographic information were also collected from the study subjects. The overall ASB prevalence was significantly higher among SCD patients (17.2%) than among the control group (8.2%), and the relative risk was 2.11 (p = 0.0431; CI = 1.00–4.45). Being female was as a predictor of ASB among the SCD patients (OR = 14.76; CI = 11.23–18.29; p = 0.0103). The most common organism isolated from the study participants was coagulase negative Staphylococcus species (4.1%), followed by Escherichia coli (2.7%); etiology of ASB in the SCD patients was more diverse compared to healthy people. All the E. coli isolates were susceptible to amikacin, sparfloxacin and norfloxacin but resistant to ampicillin.
Highlights
Urine samples are normally sterile and the presence of bacteria in urine defines bacteriuria, which is considered significant if the bacterial count is greater than 1 × 105 per mL [1,2]
The prognostic significance of asymptomatic bacteriuria (ASB) is based on the fact that it could lead to an increased risk of pyelonephritis and renal impairment in certain medical conditions such as diabetes mellitus and pregnancy [6,7]
The current study aimed to investigate the risk of ASB among sickle cell disease (SCD) patients at a tertiary hospital in Ghana
Summary
Urine samples are normally sterile and the presence of bacteria in urine defines bacteriuria, which is considered significant if the bacterial count is greater than 1 × 105 per mL [1,2]. Significant bacteriuria may be either symptomatic or asymptomatic. The former defines urinary tract infection and is associated with symptoms such as dysuria, pyuria, and frequent urination [2]. In asymptomatic bacteriuria (ASB), the accompanying symptoms of urinary tract infection are absent, and some of the associated risk groups of ASB include elderly people, and patients with diabetes, bladder catheters and sickle cell disease (SCD) [3,4,5]. In ASB, alterations in host-pathogen interaction may be responsible for the absence of symptoms despite the presence of urinary pathogens [8]
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