Clean Catch Midstream Urine Samples Research Articles

Asymptomatic Bacteriuria among Pregnant Women Attending Tertiary Care Hospital in Lucknow, India

Introduction: Asymptomatic bacteriuria (ASB) is the presence of actively multiplying bacteria within the urinary tract with absence of any symptoms, resulting in adverse pregnancy outcomes. This research study was done in order to review prevalence, antimicrobial susceptibility profile, and factors associated with ASB occurring in female patients who are pregnant and being treated at a tertiary care hospital in Lucknow, India. Method and Materials: This is a cross-sectional study done among 216 pregnant women attending a hospital for antenatal check-ups. Clean catch midstream urine samples were collected and examined microscopically, and semi-quantitative culture was done on blood agar and MacConkey agar. Isolates were identified by colony morphology and biochemical tests, and antimicrobial susceptibility testing was done by using the Kirby-Bauer method. Results: Of the 216 pregnant women, 36 (16.7%) tested positive for ASB. The female gestational period, haemoglobin level, and BMI were significantly associated with ASB. Logistic regression also showed that higher haemoglobin level was less likely to ASB (AOR = 0.42, 95% confidence interval: 0.202–0.88, p = 0.021). The predominant and usual isolates were E. coli (n = 22, 61.1%), followed by Cons (n = 6, 16.7%), and S. aureus (3, 8.3%). All Gram-negative isolates were mostly sensitive to most of the drugs like piperacillin-tazobactam, cefepime, nitrofurantoin, and meropenem but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to ampicillin, vancomycin, linezolid, and nitrofurantoin but 100% resistant to co-trimoxazole. Conclusion: The present study shows the existence of ASB was 16.7% among women who are pregnant. Pregnancy duration, haemoglobin level, and BMI were significantly associated with ASB. The isolates identified more frequently were E. coli (61.16%), Cons (16.7%), and S. aureus (8.3%). All isolates which were Gram-negative were mostly sensitive to most of the drugs but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to most of the drugs but 100% resistant to co-trimoxazole.

Antibiotic resistance: a comparison between inpatient and outpatient uropathogens

Urinary tract infection is one of the most common infections and its treatment is complicated by the emergence of antibiotic resistance. Resistance patterns of organisms differ between community-acquired and hospital-associated urinary tract infections. The aim of this study was to determine the most effective antibiotics against uropathogens and if antibiotic resistance differed by setting (inpatient versus outpatient). This 2016-2017 cross-sectional study examined 300 midstream clean-catch urine samples with positive culture (150 outpatient and 150 inpatient samples) for the uropathogens isolated and the resistance of these pathogens to different antibiotics. Samples were obtained from the laboratory of Baharloo hospital, Tehran. The differences in antibiotic resistance between inpatient and outpatient uropathogens were analysed using the chi-squared test. Escherichia coli (72.0% of the 300 samples) and Klebsiella spp (13.0%) were the most common uropathogens isolated. A greater proportion of inpatient samples showed resistance to ceftriaxone, cefixime, sulfamethoxazole-trimethoprim, ciprofloxacin and nalidixic acid than the outpatient samples (P < 0.05). The most effective antibiotics for Gram-negative uropathogens were imipenem (only 6.0% of these uropathogens overall were antibiotic-resistant), amikacin (6.3%) and nitrofurantoin (10.3%). Uropathogen resistant rates in inpatients were higher than outpatient rates. The use of imipenem and amikacin instead of traditional first-line empirical therapy (fluoroquinolone and sulfamethoxazole-trimethoprim) is advised for hospitalized patients with urinary tract infections.

Pattern of uropathogens and antibiotic sensitivity in diabetes patients attending to out - Patient department and diabetes clinic of a teaching hospital: A cross-sectional study.

Introduction:Diabetes mellitus is the most common endocrinological disease associated with different life-threatening infections. Urinary Tract Infection is one of them which may lead to Intensive care Unit admission and even death. In this study, we would like to find out the spectrum of uropathogen and its antibiotic sensitivity, so that we can choose empirical antibiotics early to save lives.Aim and Objectives:To find out spectrum of uropathogens in Diabetic patients attending to Diabetes Clinic of a tertiary hospital and to find out the Antibiotic sensitivity pattern in isolated bacteria.Material and Methods:In this cross-sectional observational hospital-based study, consecutive patients of any age and gender having Diabetes mellitus and symptoms of Urinary Tract Infection, who attended Out-patient Department and Diabetes Clinic of General Medicine Department from August 2020 to October 2020, were included. After taking consent and brief history, mid-stream clean catch urine sample was collected in sterile container and sent to a Microbiology laboratory for culture of micro-organism and sensitivity to antibiotics.Results:Among 202 diabetic patients recruited in our study, 138 (68.31%) were female and 64 (31.69%) were male. The mean age of all participants was 50.23 ± 11.45 years. Culture confirmed UTI was 24.3% and patients showing classic UTI symptoms were 32.7%. Compared to male, most of the culture-positive and symptomatic patients were female (26.0% and 37% respectively). Culture-positive patients who showed classic UTI symptoms were 42.42%; however, we found 15.44% asymptomatic patients who showed culture positivity. The mean HbA1c level was 7.5 ± 1.6%. Subgroup analysis revealed that patients with HbA1c >7.5% were at a significantly higher risk of developing culture-positive UTI (P < 0.00001, Odds ratio 21.71). Prevalence of gram-negative and gram-positive bacteria were 65.3% (32 out of 49) and 28.57% (14 out of 49), respectively. The major organism isolated were Escherichia coli (39%), Klebsiella spp. (19%), Enterococcus spp. (12%), Staphylococcus aureus (12%), and Candida spp. (6%). The sensitivity pattern of the gram-negative bacilli showed the presence of Extended-spectrum betalactamases (ESBLs) in 36.84% (11 out of 32 isolates). The bacteria grown were most sensitive to Piperacillin-tazobactam (100%), Cefoperazone-sulbactam (100%) and Meropenem (100%) whereas Fluoroquinolone and Co-Amoxyclav showed least sensitivity (43.8% and 37.5% respectively). The Staphylococcus spp. showed 100% sensitivity to Vancomycin, Teicoplanin, Linezolid whereas Penicillin-G and Ampicillin showed 12.5% sensitivity. The Enterococcus spp. revealed 100% sensitivity to Vancomycin, Teicoplanin, Linezolid, and Fosfomycin. Drug resistance is emerging in clinical isolates. Prevalence of ESBL in Enterobacteriacea was found to be 34%.Conclusion:All patients with diabetes must be searched for urinary tract bacterial colonization by simple routine urinary culture even though they are asymptomatic. Resistance to common antibiotics, particularly to oral formulations (especially Fluoroquinolones and Ampicillin) is increasing day by day due to indiscriminate use of antibiotics. This study highlighted that the policy makers should formulate antibiotic policy for rational use of antibiotics, which could help clinicians to prescribe proper antibiotics. However, regular monitoring of susceptibility pattern of urinary pathogens is essential.

Prevalence of uropathogens and their antimicrobial resistance pattern among adult diabetic patients.

The high prevalence of diabetes, urinary tract infection (UTI) in persons with diabetes, and antibiotic resistance throughout the world including India is a cause of concern for health-care providers. The study aimed to assess the prevalence of uropathogens, their resistance pattern, and associated factors of UTI among adults with diabetes. A cross-sectional study was conducted during the year 2018-2019 among 504 adult diabetic patients attending a tertiary care hospital of Bhubaneswar, Eastern India. Using recommended culture methods, clean-catch midstream urine samples were examined for the presence of pathogenic bacteria and their antimicrobial susceptibility pattern. The prevalence of UTI was 75.4% and the predominant isolates were Escherichia coli (25.6%), Enterococcus spp. (18.7%), and Klebsiella spp. (8.1%). Most of the bacteria isolates were sensitive to nitrofurantoin (80.8%), gentamicin (76.8%), and amikacin (72.1%) whereas resistant to cefpodoxime (77.6%), cefixime (70.8%), and cefadroxil (65.0%). The overall multidrug resistance (MDR) to two or more antimicrobial agents was observed in 87.4% bacterial isolates. The odds of developing UTIs were significantly higher in females with diabetes (adjusted odds ratio [AOR]: 2.04; 95% confidence interval CI: 1.33-3.13), those with Stage I/II hypertension (AOR: 1.77; 95% CI: 1.04-3.008), and those having glycated hemoglobin level >9% (75 mmol) (AOR: 2.15; 95% CI: 1.13-4.10) compared with their counterparts. The prevalence of UTI and MDR to commonly used antibiotics among diabetic patients is alarming, and thus, isolation of uropathogenic bacteria and antimicrobial susceptibility testing is crucial for the treatment of UTI in persons with diabetes.

Pregnancy and asymptomatic bacteriuria- A study from a tertiary care teaching hospital, Hyderabad

Introduction: Asymptomatic bacteriuria is found in 2 to 10% of pregnant women. Complications like acute pyelonephritis, postpartum UTI, hypertension, anemia, prematurity, low birth weight babies and prenatal death may occur if untreated. Hence early detection and treatment are of considerable importance. Materials and Methods: A crosssectional study was conducted for a period of one year. A clean catch midstream urine sample was collected from pregnant women as a part of routine antenatal screening. The samples were processed according to standard microbiological techniques –wet mount examination, gram staining, glucose test paper, culture and antibiotic susceptibility testing. Results: Of the 200 samples received from the study group, 28(14%) were culture positive. The prevalence of culture positivity was more in the third trimester (19.4%).The predominant organisms isolated were gram negative bacteria like Escherichia coli (35.7%) and Klebsiella spp (28.5%). E.coli and Klebsiella showed variable resistance to fluoroquinolones, cephalosporins, aminoglycosides, betalactam and betalactam inhibitor combination. However the isolates of E.coli were sensitive to carbapenams and polymixins. Isolates of Klebsiella spp were sensitive to Polymixins. The predictive accuracy of different screening tests with culture was calculated. The sensitivity, specificity, positive predictive value, negative predictive value of grams staining is more compared to urine wet mount examination and urine test paper method in early detection of bacteruria. Conclusion: Early detection and treatment for asymptomatic bacteriuria is of considerable importance as 40% of asymptomatic cases develop into pyelonephritis The choice of antibiotic should be based on urine culture, stage of gestation, clinical data and the characteristics of the antibiotic. Keywords: Asymptomatic bacteriuria, Antenatal women, prevalence, Glucose test paper, Urine culture, Wetmount examination, Gram staining, Perinat

Study of association of urinary tract infection with preterm labour

Preterm labour is the onset of labour before 37 weeks and after 28 weeks of gestation as observed by regular uterine contractions leading to progressive cervical changes. UTI is one of the many etiological factors of preterm labour. In pregnant women UTIs are classified either as asymptomatic bacteriuria (ASB), or symptomatic infections such as acute cystitis and acute pyelonephritis. The objective of this study is to study the prevalence of UTI in preterm labour in relation to selected variables of interest like age, parity, socio economic status, literacy and background.525 cases of preterm labour were studied in a period of 18 months from December 2019 to June 2020 in the Department of Obstetrics and Gynaecology, Trichy SRM Medical College Hospital. Clean catch midstream urine samples were collected from all cases. Two samples were collected and subjected to microscopic examination and culture and sensitivity.158 cases were found to have UTI which was more prevalent among the illiterate and lower socio economic class population. It was found that UTI was more prevalent among multipara in the age group of 25 to 29 years. E-coli was the most common organism isolated (69%).Majority of the cases were booked and from rural background. Around 1.3% of cases were complicated by pyelonephritis.

Prevalence of urinary tract infections and its antibiogram in diabetic and non-diabetic patients attending tertiary care hospital in Maharashtra

Objective: To compare the prevalence of UTI in diabetic and non-diabetic patients and to compare its antibiotic resistance pattern. Materials and Methods: A cross-sectional study was conducted in 228 diabetic and 228 non-diabetic patients from November 2016 to January 2018. After obtaining an informed consent, clinical data was collected using pre-structured questionarre. Clean catch mid-stream urine sample were collected and processed for identification of uropathogens through culture using standard microbiological procedure. Antibiotic susceptibility test was carried out using Kirby Bauer Disk Diffusion method. Result: The prevalence of UTI in diabetic patients is 15.35% which is greater compared to 12.28% in non-diabetic patients. E.coli was found to be most predominant organism in both diabetic and non-diabetic patients. The most frequently isolated organism in case of diabetic were E.coli (51.42%), K.pneumonie (17.14%), MRSA (8.57%), Pseudomonas aeruginosa (5.71%), MSSA (2.85%), Citrobacter species(2.85%), CONS (2.85%), Candida (2.85%) and two samples showed mixed flora. In case of non-diabetic patients, organisms isolated were E.coli (50%), K.pneumonie(14.28%), MRSA (10.71%), Pseudomonas aeruginosa (10.71%), MSSA (3.57%), Citrobacter species(3.57%), CONS (3.57%) respectively. E.coli isolates from UTI of diabetic patients showed significantly higher resistance rates to CIP, CTX, CAZ, GEN, NIT compared with those from non-diabetic patients. The overall multidrug resistance was observed in 32 out of 35 bacterial isolates in diabetic patients (91.4%). Conclusion: Prevalence of UTI among diabetic and non-diabetic pts is comparable with published articles. Because of great proportion of asymptomatic bacteruria in diabetic pts, urine culture should be performed in all diabetic pts. Most common uropathogen is E.coli. Keywords: Diabetes, non-diabetic, Urinary tract infections, Antibiotics, Uropathogens.

Asymptomatic bacteriuria

Introduction: Asymptomatic bacteriuria (ASB) is a condition characterised by significant infection in urine. Its association with diabetes mellitus is strongly suggested. However, the exact prevalence has been controversial. Objectives: The study was undertaken with the aim of evaluating the prevalence and aetiology of asymptomatic bacteriuria in diabetics as well as non-diabetics. Materials and Methods: A total of 460 patients were included in the study with 230 diabetics and 230 non-diabetics. Midstream clean catch urine samples were collected alongwith parallel blood samples for estimating the glycosylated haemoglobin levels. Results: Of the total 460 subjects, 78 (17.0%) had ASB with 56 in diabetics and 22 in non-diabetics, depicting a higher rate of ASB in diabetes mellitus. Majority of the patients who had ASB were aged more than 60 years, irrespective of whether in the diabetic or non-diabetic category. Also, there was a significant difference in the type of infective organism in urine from diabetic patients as compared to the non-diabetic patients. Conclusion: A higher prevalence rate of ASB was observed in diabetic patients as compared to non-diabetics. Furthermore, the newer infecting organisms that are more common in patients with diabetes mellitus was highlighted in the study. Keywords: Asymptomatic bacteriuria, Urine, Diabetes, Glycosylated haemoglobin

Prevalence Of Urinary Tract Infections (Utis) Among Pregnant Women Attending Antenatal Clinic At Ile –Ife, Southwestern Nigeria

Abstract Introduction/Objective This is a prospective study that reports the prevalence of Urinary Tract Infections (UTIs) and the bacteriological causative agents among pregnant women attending antenatal clinics at a Secondary Care Hospital in Ile Ife, South western Nigeria. 335 mid-stream clean catch urine samples were collected from pregnant women between April -July 2017. Methods These were cultured for the presence of bacterial pathogens. All the isolates were subjected to antibiotic sensitivity testing on Mueller Hinton agar by modified Kirby-Bauer disk diffusion technique using CLSI, guidelines. Data were analysed using SPSS for Windows version 16 and WHONET 5. Results A total of 190 showed significant bacterial growth while 145 showed no significant bacterial growth. Bacterial agents isolated included Klebsiella spp. showing the highest occurrence of [60(31.5%) followed by Escherichia coli and Staphylococcus aureus with prevalences of [49(25.7%) and [32(16.8%) respectively. Other organisms implicated are Proteus mirabilis [20(10.5%), Coagulase Negative Staphylococci [24(12.3%) and Pseudomonas aeruginosa with the least prevalence of [5(2.6%). Resistant to antibiotics such as amoxycilin 64%, gentamicin 52.6%, erythromycin 62.5%, ceftazidime 69%, cefotaxime 74%, ceftriaxone 79.6% while a high sensitivity to tetracycline (88.5%), nitrofurantoin (96.3%), imipenem (100%) respectively. Conclusion This study indicated a high prevalence of UTIs (56.7%) in pregnant women though most of them showed no clinical manifestation.

Urinary Tract Infection in Pregnant Women at Kathmandu, Nepal

Background: Urinary tract infections “UTIs” are one of the frequently encountered problems during pregnancy. Untreated UTI can be associated with serious obstetric complications. Hence the management and prevention of UTI in pregnancy is the crucial factor for the sustained pregnant period. Hence the present study was designed to identify the pathogenic agents of UTI and its associated risk factors in antenatal mothers in two private hospitals at Kathmandu city.&#x0D; Aim: The main objective of the study was to identify the etiological agent and associated risk factor in Urinary tract infection among pregnant women attending the antenatal care service visit in a selected hospital.&#x0D; Study Design: Cross-sectional descriptive study.&#x0D; Place and Time of Study: The study was carried out under the supervision of University and field study was carried out in Kathmandu, Nepal from March 2019 to October 2019.&#x0D; Methods: The cross-sectional study was performed at the Norvic Hospital and Baidya and Banskota hospital from March 2019 to October 2019. In this cross-sectional study, a total of 510, clean catch midstream urine (MSU) samples were collected aseptically and analyzed using standard microbiology methods. Data for the factors associated with UTI were obtained by use of questionnaires and standard laboratory tests for selected underlying conditions concerning associated risk factors were collected using structured questionnaires and the sample was also processed for antimicrobial drug susceptibility testing.&#x0D; Results: The study revealed 193/510(37.84%) UTI prevalence among patients attending two hospitals in Kathmandu valley. Escherichia coli was the most prevalent bacterial uropathogen with 119/193(61.6%) followed by Klebsiella pneumoniae 35/193(18.13%), Staphylococcus aureus 22/193 (11.39%), Proteus mirabilis 7/193 (3.6%), Enterococcus faecalis 2/193 (1.0%), Enterobacter aerogenes2/193(1.0%) Serratia odorifera 3/193(1.5%), Streptococcus species3/193(1.5%).&#x0D; Conclusions: The high prevalence of urinary tract infection in pregnant women warrant the need to screen all pregnant women and treat those infected with appropriate antimicrobial regimens in order to reduce its complications. Urinary Tract Infection screening is essential in pregnant women.

Epidemiological and Bacteriological Profile of Urinary Tract Infection and the Antibiotic Sensitivity Pattern of Causative Organisms in National Medical College and Teaching Hospital - A Retrospective Cross-Sectional Study

Background: Urinary tract infections (UTIs) are one of the most common infectious conditions seeking treatment. There are varieties of microorganisms associated. The bacteriological investigations are incomplete without antibiotic sensitivity test of the isolate. Our aim is to determine age and sex distribution of UTI, bacteriological profile, and antibiotic sensitivity pattern of the organisms.&#x0D; Materials and Methods: A retrospective cross-sectional observational study of records of patients with clinically suspected UTI from Kartik 2076 to Magh 2076 was conducted at National Medical College and Teaching Hospital (NMCTH). It included both inpatient and OPD visit patients who submitted their clean-catch midstream urine sample for culture and antibiotic sensitivity at Microbiology lab of NMCTH.&#x0D; Result: Out of 385 patients, 103 (26.75%) showed bacterial growth. Escherichia coli (47.58 %) was the most common organism followed by Staphylococcus sps. (18.45%) and Klebsiella sps.(17.47%) respectively. There was female dominance (62.13%) but male were predominantly affected in children and older population. The most common age group for UTI was 21-30 years (mean age 25 years) and females were more affected than males. The most common pathogen was Escherichia coli, followed by Staphylococcal sps. and Klebsiella. All the organisms showed best sensitivity to tigecycline (100%).&#x0D; Conclusion: This study highlights the common pathogens causing UTI and their antibiotic sensitivity patterns which could help clinicians in starting rational empirical antibiotic therapy for such patients while awaiting urine culture reports.

Prevalence and antibiotic susceptibility pattern of bacteriuria among HIV-seropositive patients attending the Bamenda Regional Hospital, Cameroon.

HIV causes a decrease in CD4+ lymphocyte cells count, exposing the individual to infections (urinary tract infections). This study was carried out to determine the prevalence of bacteriuria and antimicrobial susceptibility pattern of bacteria isolates among HIV patients. Clean catch mid-stream urine samples were collected from 135 HIV- seropositive patients, cultured on Cystein lactose electrolyte deficient (CLED) agar and incubated at 370C for 24 hours. The modified Kirby-Bauer's disc diffusion method was used to assess susceptibility to antimicrobial agents. The prevalence of bacteriuria was 67.4% (91/135). Staphylococcus aureus was the most predominant (42.9%) isolate, followed by Escherichia. coli (24.2%), then Coagulase negative Staphylococci (10.9%). The highest proportion of bacteria was isolated from patients having a CD4+ T-cell count of less than 300 cells/mm3 (39.6%). There was an association between the level of CD4+cell count and bacterial urinary tract infection (P= 0.001). Most sensitive drugs were gentamycin, vancomycin and amoxicillin-clavulanic acid while the drug with the greatest resistance was sulphamethoxazole-trimethoprim, with Enterococcus and Proteus showing 100% resistance to this drug. Bacteriuria and resistance to commonly used antibiotics is prevalent among HIV/AIDS patients attending the Bamenda Regional Hospital. Therapy based on antimicrobial susceptibility test is encouraged.

Antibiotic Sensitivity in UTI among Diabetic Pregnant Women

Background: Urinary tract infection (UTI) is common during pregnancy and especially soin pregnant patients with diabetes mellitus. The emergence of drug resistance and particularlythe extended spectrum Beta-lactamase production by Escherechia Coli and Methicillinresistance in staphylococci, limits the choice of anti-microbials.&#x0D; Method: A cross-sectional study was conducted on 50 pregnant women with sign andsymptoms of UTI in the Department of Obstetrics and Gynaecology, BIRDEM generalHospital-2 from January to June 2017. The objectives of the study were to determine thepresence and type of pathogens found in pregnant diabetic women presenting with featuresof urinary tract infection, and to analyze their antibiotic sensitivity pattern. Clean catch midstreamurine samples were collected using standard procedure and culture and sensitivitywas done following standard bacteriological method.&#x0D; Results: Mean age of the study subjects was 29.84±5.29 yrs; 48% were in third trimester ofpregnancy; 52% had Gestational Diabetes Mellitus (GDM) and 48% had Diabetes Mellitus(DM). Out of fifty pregnant women, thirty eight (76.0%) study subjects had positive growth.Of them, Escherechia coli was found in 57.9% cases, Klebsiellain 21.1%, Staphylococcusaureus in 7.9%, Enterococcus and Pseudomonas aeruginosa each in 2.6% case. Amikacinwas found to be sensitive to 100% cases of E. Coli, Klebsiella&amp; Enterococcus but 100%resistant to Streptococcus.&#x0D; Conclusion: In this study, E. Coli was the most common organisms causing UTI, which isless susceptible to conventional oral antibiotics but more susceptible to amikacin. So carefulldrug selection is required for successful outcome in UTI.&#x0D; Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 54-58

Monitoring Antimicrobial Susceptibility in bacterial isolates causing Urinary Tract Infections in a Tertiary Hospital in Kathmandu

&#x0D; Urinary tract infection is the most common infection in females worldwide. One in three women experiences at least one episode of urinary tract infection during their lifetime. The objective of this study was to determine the etiology and antimicrobial profile of urinary tract infection. A cross-sectional study was conducted at a tertiary care hospital in Nepal. Thirteen hundred clean catch mid-stream urine samples were tested through standard microbiological techniques. The isolates from urine samples were identified from biochemical tests. Antibiotic susceptibility testing was performed through the Kirby-Bauer disc diffusion technique following CLSI guidelines. The prevalence of urinary tract infection was found at 24.23%. Escherichia Coli was a predominant etiological agent followed by Staphylococcus aureus. The majority of the infection was found between the age group 21-40, with females mostly infected. Most of the microorganisms were isolated from emtergency, obstetrics-gynecology, and nephrology wards. Most of the isolates were resistant to ampicillin, whereas the majority of the gram-positive isolates were resistant to penicillin.A large number of isolates were found to be sensitive to Gentamycin and nitrofurantoin. Routine antimicrobial susceptibility testing of the isolates causing urinary tract infection is recommended to reduce antimicrobial resistance and for the proper treatment of infection.

Prevalence of Candida spp. Isolated from Urine Samples of Pregnant Women from Kassala State, Sudan

A urinary tract infection (UTI) is a major disease that affects people of all age groups. Women are more susceptible to UTI than men especially pregnancy, mainly due to the different structural features make easy contamination of the UTI with fecal flora. Candida is one of pathogenic which causing this problem. A total of 196 Clean-Catch midstream urine samples were collected from pregnancy referred to Kassala new Hospital and Abdurrahman Elmobark Medical center, their ages between 15 to 40 year old. Grams’ staining, chlamydospores formation and Chromogenic Agar medium used to differentiate between Candida spp. 17 (8.67%) were positive for Candida species, these were C. glabrata (41.18%), C. albicans (23.52%), C. krusei (17.66%), C. dubliniensis (11.76%) and C. tropicalis (5.88%). No co-existence of Candida species was found. In the present study C .glabrata and C. albicans scored the highest frequency of occurrence.

Multi-drug resistant and extended-spectrum \u03b2-lactamases producing bacterial uropathogens among pregnant women in Northwest Ethiopia

IntroductionAbove 80% of urinary tract infections are caused by enteric bacteria, which are known for years by their drug-resistant ability. Though the prevalence of drug-resistant strains is increasing in the world, it is not well known in low-income countries. The aim of this study was to assess the prevalence of Multi-drug resistance, Extended-spectrum β-lactamases production, and associated risk factors among pregnant women in Northwest Ethiopia.MethodsA hospital-based cross-sectional study was conducted among pregnant women from March to May 2017. A total of 384 clean-catch midstream urine sample was collected from study participants. Bacterial identification and drug susceptibility testing were done following standard microbiological techniques; Extended-spectrum β-lactamase production was screened using a disc diffusion test and confirmed by a combination disc test. The data were entered and analyzed by using SPSS version 20, and a p-value of less than 0.05 was considered as statistically significant.ResultThe overall prevalence of urinary tract infection was 15.9% (95% CI 12.8–20.1%). E. coli (49.2%), CoNS (27.9%), and S. aureus (18%) were the main uropathogens. The prevalence of MDR uropathogens was 60.65%. The prevalence of ESBLs production among cases caused by Enterobacteriaceae was 18.2%. The drug resistance rate of Gram-negative isolates was higher for ampicillin (90.9%), cephalothin (84.8%), and augmentin (57.6%). The drug nitrofurantoin showed the highest activity (100%) against Gram-negative isolates. Gram-positive isolates were showed low susceptibility to penicillin (89.3%) and cotrimoxazole (75%); however highest susceptibility rate for gentamicin (100%), amikacin (100%), and nitrofurantoin (98.36%) was recorded. Prior antibiotic therapy (AOR = 5.46, 95% CI 1.38–21.65) was a risk factor for the presence of multi-drug resistant bacteria.Conclusion and recommendationThe multi-drug resistance prevalence was high among uropathogen, thus treatment of urinary tract infection during pregnancy; should be based on the antibacterial susceptibility testing result. The isolation of drug-resistant strains like Extended-spectrum β-lactamases in this study calls for the need of periodic and continuous follow-up of antibiotic usage among pregnant women. Nitrofurantoin, gentamicin, amikacin, and ciprofloxacin/norfloxacin showed higher activity against bacterial uropathogen.

Antimicrobial Susceptibility Profile of Urinary Tract Pathogenic Infections in Diabetic Patients Attending a Health Facility in Kumasi, Ghana

Aims: This study seeks to investigate the antimicrobial susceptibility profile of urinary tract pathogenic infections in diabetic patients attending a health facility in Kumasi, Ghana.&#x0D; Study Design: A total of 285 patients were recruited using Cochran’s formula at a prevalence of 26.4% for this study from patients attending the University Hospital from April 2018 to October 2018. Data were collected using a structured questionnaire.&#x0D; Methodology: Clean-catch midstream urine samples were screened for the presence of pathogenic bacteria and their antimicrobial susceptibility pattern using recommended culture methods.&#x0D; Results: Out of the 285 patients, 125 (43.9%) were diabetic with 90 (72%) being female and 35 (28%) male. There was no association between UTI’s and gender (P=0.5799) with diabetic patients recording higher bacteriuria compared to non-diabetics (P&lt; 0.001). Isolates from 113 (39.4%) of the samples were identified and these included, Escherichia coli, Pseudomonas species, Klebsiella species, Proteus species and Staphylococcus aureus. The most predominant was E. coli 62 (54.9%) followed by S. aureus 24 (21.2%), Klebsiella species 14(12.4%), Pseudomonas species 12(10.6%) and Proteus species 1(0.9%). E. coli showed a high antimicrobial sensitivity rates against most of the tested antibiotics, gentamycin (90.3%), amikacin (98.4%), nalidixic (34%), cefotaxime (80.6%) and nitrofurantoin (93%). Proteus spp. on the other hand, showed a 100% sensitivity to all the antibiotics except tetracycline, amikacin and cefotaxime. It was observed that Escherichia coli was mostly resistant to tetracycline (96.8%), norfloxacin (69.4%) and cefotaxime (61.4%).&#x0D; Conclusion: S. aureus showed a higher level of resistance to tetracycline (100%). The prevalence of this study indicated that UTI among diabetic patients was relatively comparable with other studies. Amikacin and nitrofurantoin should be recommended as antimicrobials for the treatment of UTIs whilst the use of tetracycline, norfloxacin and cefotaxime should be discouraged.

Candidiasis among diabetic patients attending Aminu Kano teaching hospital, Kano-Nigeria

Candidiasis is a yeast infection caused by the species of the genus candida that lives as commensal in/on some parts of the body, like gastrointestinal tract, respiratory tract, vagina and even on the skin. However, they later change to opportunistic pathogens under certain conditions especially in suger environment like in diabetic patients, because they are suger loving organisms. The study was to identify the extent of Candida infections among diabetic patients. During the study,Clean catch midstream urine samples were collected from the participants, the samples were inoculated onto Sabouraud Dextrose Agar (SDA) and incubated at 37oC for 48h. Gram’s staining technique, germ tube test and KOH test were the techniques performed on purity plate before subculture on to Chromogenic agar for phenotypic speciation of the isolates. A prevalence of 16.2% was observed with four different candida species (Candida albicans 45.7%, Candida krusei28.6%, candida glabrata 20% and Candida tropicalis 5.7%) isolated. Infection rate according to gender, the result showed that female were the most affected than males and age limit of 31-45 was the most infected group based on the study followed by 46-60 age range while the age range of 16-30 had the least infection rate in the study.

Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale Hospital, Eastern Uganda.

Asymptomatic bacteriuria in pregnancy (ASBP) is associated with adverse pregnancy outcomes such as pyelonephritis, preterm or low birth weight delivery if untreated. The aim of this study was to determine the prevalence of asymptomatic bacteriuria, the isolated bacterial agents, and their antibiotic sensitivity patterns in pregnant women attending antenatal care at Mbale Hospital. This was a cross sectional study in which 587 pregnant women with no symptoms and signs of urinary tract infection were recruited from January to March 2019. Mid-stream clean catch urine samples were collected from the women using sterile containers. The urine samples were cultured using standard laboratory methods. The bacterial colonies were identified and antibiotic sensitivity was done using disc diffusion method. Chi squared tests and logistic regression were done to identify factors associated with asymptomatic bacteriuria. A p value < 0.05 was considered statistically significant. Out of the 587 pregnant women, 22 (3.75%) tested positive for asymptomatic bacteriuria. Women aged 20-24 years were less likely to have ASBP when compared to women aged less than 20 years (AOR = 0.14, 95%CI 0.02-0.95, P = 0.004). The most common isolates in descending order were E. coli (n = 13, 46.4%) and S.aureus (n = 9, 32.1%). Among the gram negative isolates, the highest sensitivity was to gentamycin (82.4%) and imipenem (82.4%). The gram positive isolates were sensitive to gentamycin (90.9%) followed by imipenem (81.8%). All the isolates were resistant to sulphamethoxazole with trimethoprim (100%). Multidrug resistance was 82.4% among gram negative isolates and 72.4% among the gram positive isolates. There was high resistance to the most commonly used antibiotics. There is need to do urine culture and sensitivity from women with ASBP so as to reduce the associated complications.

Prevalence of Candidiasis amongst Undergraduate Students of COOU, Uli, Nigeria

Most urinary tract infections are due to Candida species, C. albicans being most prevalent. Laboratory research study was used to examine the prevalence of candidiasis amongst undergraduate students of Chukwuemeka Odumegwu Ojukwu University, Uli. A total of 100 students were investigated. Clean catch midstream urine samples were used for the analysis. Standard microbiological procedures were utilized. A structured questionnaire was issued to each student to obtain their socio-demographic data.Our study found Candida albicans in 14(14%) of the urine samples.Significant candidiasis was strongly associated with being female as higher percentage of the isolates were from female students. Of the 14(14.0%) positive urine samples, 4(28.6%) were from symptomatic students, whereas 10(71.4%) were asymptomatic.