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Antimicrobial Use and Susceptibility Pattern of Uropathogens Associated with Urinary Tract Infections at the Ghana Police Hospital
Abstract and Figures
The changing pattern of urinary tract pathogens to antibiotics have been reported worldwide.
To ensure appropriate treatment, knowledge of antibiotic susceptibility of pathogens is mandatory. The
objective of this study was to determine the prevalence and antibiotic susceptibility pattern of microorganisms
isolated from urine samples of UTI patients at the Ghana Police Hospital’s Laboratory vis-à-vis the current UTI
drug management pattern at the Hospital. The study involved analyzing urine samples of UTI patients who
reported to the Ghana Police Hospital Laboratory from 1st July 2011 – 31st December 2011. Prevalence,
uropathogen sensitivity pattern and drug management of UTI were assessed. Prevalence of UTI among 708
samples analyzed was 31.6%. The predominant bacterial isolates were Coliforms (44.2%) and Escherichia coli
(36.2%). High susceptibility of bacteria was seen with Nitrofurantoin and Gentamicin. Out of the 120 drug
managed cases, 83.2% had single drug therapy and drugs prescribed conformed to national standard treatment
guidelines (STGs). In summary, pathogens showed resistance to a substantial number of antibiotics tested but
susceptibility was observed with Nitrofurantion and Gentamicin. Most common drug used in the management
of uncomplicated UTI was Ciprofloxacin
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... This study addressed antibiotic resistance of pathogens associated with urinary tract infections in patients seeking medical care in a secondary and tertiary care facility, intending to provide data to improve the efficient treatment of infections. The overall prevalence of UTI was 33.8%, which is comparable to the reported rates of 31.6% in Accra, Ghana, 11 and 32.2% in Abbreviations: nT, not tested; SXT, trimethoprim-sulfamethoxazole. ...
... 18,20 In a related study at the Ghana Police Hospital in Accra, more males than females presenting with UTI infections were also described. 11 Many UTI studies usually report a common occurrence of higher prevalence in females, 3,19,21,22 which contradicts our record in the Teaching hospital; however, the greater recovery of pathogens from the urine of our female patients corroborates these literature reports. ...
... 23 Escherichia coli was the leading pathogen among isolated Gram-negatives (Klebsiella sp, Enterobacter sp, Serratia sp, Salmonella sp., and Proteus sp.) in this study, which is consistent with studies in Ghana and other countries. 11,17,18 Quite some Serratia sp. were isolated from our patients. These species, according to reports, are gradually gaining notoriety for catheter-associated infections, urologic obstructions, recurrent, and nosocomial infections. ...
As global studies report varying trends in antibiotic susceptibility of uropathogens, it is necessary to have current and constant information on the prevalence of urinary tract infections, the causative pathogens, and their susceptibility profiles, for effective management in specific geographical settings. This prospective cross-sectional study focused on the prevalence of urinary tract infections, etiological agents, and their antibiogram in a secondary and tertiary care hospital in Northern Ghana. Urine samples collected from 219 patients of all age groups were cultured on cysteine lactose electrolyte deficient agar. Pathogens were identified following standard microbiological methods, and their susceptibility to antibiotics was determined by the Kirby-Bauer disk diffusion method. Approximately 34% of the patients had significant bacteria, but the prevalence was slightly higher (P = .763) in the Tertiary care hospital (37.3%) than in the Secondary hospital (30.3%). Patients who were 60 years and above (27.0%) were commonly found with UTIs followed by the year group 20 to 29 years (20.3%). Although all the diagnoses had a positive relationship with urinary tract infection except Pyelonephritis, none of the underlying conditions was a significant (P > .05) predictor of urinary tract infection, with the odds ratio indicating that patients with hyperparathyroidism and dysuria had 2.606 times more likely increased risk or predictor of urinary tract infection. Ten different pathogens were identified, but Escherichia coli and Staphylococcus saprophyticus were frequently encountered. Gram-negative isolates generally showed more resistance. High resistance against ampicillin (100%), trimethoprim-sulfamethoxazole (88.5%), chloramphenicol (84.6%), augmentin (69.2%), ceftriaxone (69.2%), and ciprofloxacin (61.5%) were recorded. Amikacin was relatively effective against isolated pathogens. The high records of resistance among uropathogens and the occurrence of multidrug resistance (92%) reiterate the urgent call for rigorous surveillance of antimicrobial resistance among infectious pathogens in Ghana.
... The advancing age are commonly associated with risk factors including reduced immunity, co-morbid diseases such as diabetes mellitus, chronic heart diseases, neurogenic bladder [13,16] whilst in infants, lack of fully developed immunity, malnutrition as well as inadequate hygiene [17] put them at greater risk of infections. Urinary tract infection (34.5%) was most prevalent within the period of our study, and is comparable to 31.5% reported from a study on prevalence and antibiotic susceptibility pattern of uropathogens conducted in secondary hospital in Ghana [18]. Our study found, E. coli and K. pneumoniae as most predominant pathogens implicated in UTI. ...
... Several studies conducted in the region and other parts of the country have reported UTI as most common infections frequently caused by E.coli and K. pneumoniae with high resistance to broad spectrum antibiotics, that remains a major clinical problem in health care system in Ghana [19,20]. Among the isolates, E. coli, K. pneumoniae Proteus mirabilis, P. aeruginosa, Enterobacter, Acinetobacter and Serratia spp. in the present study have been reported as clinically important urine pathogens [18,21], associated with about 90% of both community and hospital acquired UTIs [22,23]. Urinary tract infection prevalence was high among infants and the middle aged with incidence higher in females (10.8%) than the males (6.6%) in the middle age group. ...
Background
Multidrug-resistant Gram-negative bacteria have emerged as major clinical and therapeutic dilemma in hospitals in Ghana.
To describe the prevalence and profile of infections attributable to multidrug-resistant Gram-negative bacteria among patients at the Komfo Anokye Teaching Hospital in the Ashanti region of Ghana.
Methods
Bacterial cultures were randomly selected from the microbiology laboratory from February to August, 2015. Bacterial identification and minimum inhibitory concentrations were conducted using standard microbiological techniques and the Vitek-2 automated system. Patient information was retrieved from the hospital data.
Results
Of the 200 isolates, consisting of K. pneumoniae , A. baumannii , P. aeruginosa , Enterobacter spp. , E. coli , Yersinia spp. , Proteus mirabilis , Pasteurella spp., Chromobacterium violaceum, Salmomella enterica , Vibrio spp. , Citrobacter koseri , Pantoea spp. , Serratia spp. , Providencia rettgeri Burkholderia cepacia , Aeromonas spp. , Cadecea lapagei and Sphingomonas paucimobilis , 101 (50.5%) and 99 (49.5%) recovered from male and female patients respectively The largest proportion of patients were from age-group ≥60 years (24.5%) followed by < 10 years (24.0%) and least 10–19 years (9.5%) with a mean patient age of 35.95 ± 27.11 (0.2–91) years. The decreasing order of specimen source was urine 97 (48.5%), wound swabs 47 (23.5%), sputum 22 (11.0%) bronchial lavage, nasal and pleural swabs 1 (0.50%). Urinary tract infection was diagnosed in 34.5% of patients, sepsis in 14.5%, wound infections (surgical and chronic wounds) in 11.0%, pulmonary tuberculosis in 9.0% and appendicitis, bacteremia and cystitis in 0.50%. The isolates showed high resistance to ampicillin (94.4%), trimethoprim/sulfamethoxazole (84.5%), cefuroxime (79.0%) and cefotaxime (71.3%) but low resistance to ertapenem (1.5%), meropenem (3%) and amikacin (11%). The average multi-drug resistance was 89.5%, and ranged from 53.8% in Enterobacter spp. to 100.0% in Acinetobacter spp. and P. aeruginosa .
Conclusion
Bacterial infections caused by multi-drug resistant (isolates resistant to at least one agent in three or more antibiotic classes) Gram-negative pathogens among patients at Komfo Anokye Teaching Hospital in Kumasi, Ghana are rife and interventions are necessary for their containment.
... The most frequent HAIs in the current study were surgical site infection and pneumonia, similar to results from earlier studies 14,15 but consistent with data from an Iranian study . 16 About 50% of patients were infected by urinary tract infection in the medicine ward, which is more than the reported rates of 31.6% in Accra, Ghana, 17 and 32.2% in Uganda. 18 About 58% of patients developed SSI in emergency surgery which is similar to other studies. ...
Introduction: Healthcare-associated infections represent significant obstacles to providing high-quality healthcare and have been directly linked to ineffective infection control procedures. There is currently a shortage of trustworthy data in Bangladesh describing the epidemiology of hospital-acquired infections (HAIs), which is necessary for the development of effective infection prevention and control measures. This study's goal was to assess the frequency, nature, and risk factors of HAIs in acute care hospitals in Northern Bangladesh. Methods: This was a pilot point prevalent survey conducted in the medicine, surgery, gynecology, and obstetrics departments of Rajshahi Medical College Hospital between August 2022 to September 2022. Data were collected by two questionnaires for disease profile and hospital-acquired infection. In addition, a checklist was used for the observation of the infection prevention and control (IPC) status of different wards. Result: Approximately 900 patients' data were collected during this time period. The overall prevalence of HAI was found to be 3.7%. The prevalence of HAI, especially surgical site Infection (SSI), in the obstetrics ward, was 4.2%, and the Medicine ward was 3.9%, respectively. The prevalence of hospital-acquired infection in the surgery ward is 7.7%. Approximately 41.7% of patients developed SSI on the 6th post operative day (POD). The Infection prevention and control status of different wards was similar, which was not satisfactory. Conclusion: This surveillance might help concerned authorities and policymakers by making some crucial steps to monitor and reduce hospital-acquired infections and HAIs in hospitals. TAJ 2022; 36: No-1: 9-15
... Similar studies in Ghana and the Sub-Saharan African region depict similar findings. The finding of this study is comparable to other studies that determined similar trends in gram-negative infection patterns [20][21][22]. Studies in Korea also came to the finding implicating Enterobacterales such as E. coli, and K. pneumoniae as the major causative organism in urinary tract infections [23]. ...
Background: A variety of clinically important pathogens have developed multidrug resistance (MDR), which threatens global public health. This study aimed to determine the incidence, patterns, and trends of MDR of gram-negative bacterial isolates in clinical specimens in the Tamale Teaching Hospital, Ghana.
Methods: This retrospective study analyzed gram-negative bacterial isolates and antimicrobial susceptibility test (AST) results of patients who visited the Tamale Teaching Hospital laboratory between 2017 and 2019.
Results: A total of 2,779 gram-negative bacterial isolates and their phenotypic AST results were analyzed. From these, 1,297 gram-negative bacteria (46.7%) were isolated from urine samples, while the rest were isolated from sputum (20.9%), wound (14.3%), and swabs
(11.7%) samples, etc. Escherichia coli (23.8%) was the most common gram-negative pathogen found predominantly in the urine samples (33.2%). All gram-negative bacteria isolated between 2017 and 2019 showed high MDR. Klebsiella pneumoniae gradually increased its
MDR from 84.0% in 2017, 89.5% in 2018, to 95.1% in 2019. On the other hand, the MDR rates in Pseudomonas aeruginosa were approximately 65.8%, varying from 59.5% in 2017 to 78.7% in 2019. Among tested antimicrobials, amikacin was the most effective. Resistance to amikacin in Enterobacter spp., E. coli, and K. pneumoniae in vitro were 16.2%, 11.8%, and 17.7%, respectively.
... Similar resistant trend in catheterized Bladder Outlet Obstruction (BOO) patients recording 92.3% and 74.2% for E. coli and K. pneumoniae to ciprofloxacin [14] but contrary to a recorded 100% resistance for isolated uropathogen [28]. The resistance to ciprofloxacin could be attributed to the fact that ciprofloxacin is the commonest antibiotic used by the most catheterized patients in Ghana [6] [29]. Cefazolin and nitrofurantoin resistance to Klebsiella were significantly higher compared to either S. aureus or E. coli. ...
... The advancing age are commonly associated with risk factors including reduced immunity, co-morbid diseases such as chronic heart diseases, diabetes mellitus, neurogenic bladder [12,13] whilst in infants, lack of fully developed immunity, malnutrition as well as inadequate hygiene [14] put them at greater risk of infections. In a study conducted in Ghana, urinary tract infection was 31% [15].Respiratory system diseases,DM,renal diseases,HL,HT were in our patients risk factors. MDR A. baumannii is a problematic, multidrug-resistant pathogen identifed in healthcare settings worldwide, especially in ICUs [16]. A. baumannii has a notable ability to capture and express resistance genes. ...
Acinetobacter baumannii (AB) is a ubiquitous gram-negative coccobacillus that has the ability to colonize and survive in a variety of environments and develop various resistance mechanisms. In our study; Between 2010 and 2012, 5400 patients were screened, 74 of them had MDR AB infection. MDR AB infection is associated with high morbidity and mortality.
... Though there is antimicrobial resistance to a large extend, some studies show there were susceptibility of uropathogens to some antibiotics. In Ghana, Gyansa-Lutterodt and associates found high susceptibility of uropathogens to Nitrofuantoin and Gentamicin at the Police Hospital, while Gyasi-Sarpong et al reported susceptibility of uropathogens to ciprofloxacin, nalidixic acid, cefuroxime, ceftriaxone and cefotaxime at the Komfo Anokye Teaching Hospital[30] [32]. In order of decreasing susceptibility, we report that Amikacin 83.0%, Levofloxacin 38.6% and Ciprofloxacin 29.5% were the antibiotics found to be most suitable in treatment of urinary tract infection at the Tamale Teaching Hospital. ...
... While some studies [7][8][9] have reported the overall prevalence of ASB particularly in pregnancy to be between 10.0% and 40.0%, a few studies have also reported different prevalence rates of ASB ranging from 13.3% to 28.8% [10]. Previous studies [11][12][13] in the Ghanaian population have reported high ASB prevalence rates. A cross-sectional study conducted among pregnant women attending antenatal clinic reported a 7.3% prevalence rate of ASB [11]; another cross-sectional study by Gyansa-Lutterodt et al. reported a prevalence rate of 31.6%, while a recent study found that 9.6% of female tertiary students tested positive for asymptomatic bacteriuria [14]. ...
Background: Asymptomatic bacteriuria (ASB) poses serious future clinical repercussions for reproductive women. The study determined the prevalence of asymptomatic bacteriuria along with anti-microbial susceptibility patterns among women of reproductive age in a primary care facility. Method: The study recruited a total of 300 women of reproductive age attending the Tetteh Quarshie Memorial Hospital at Akuapem-Mampong, Ghana, between January and March 2018. Questionnaires were administered to obtain demographic data and predisposing risk factors of ASB. An early-morning midstream urine sample was collected from participants. Urinalysis, urine culture, and anti-microbial susceptibility testing were performed. Results: The mean age of participants was 25.43 years. The overall prevalence rate of ASB was 40.3%. The prevalence was higher among pregnant women compared to non-pregnant women (33.3% vs 7.0%). The most common bacterial isolate was E. coli (47.0%) followed by Proteus spp. (36.4%), Klebsiella spp. (8.3%), and E. faecalis (8.3%). Leukocyturia (35.0%) followed by nitrate (30.0%) were the most common urine abnormalities identified on dipstick urinalysis. Most bacteria isolates showed increased resistance to ampicillin (95.04%) and tetracycline (95.04%) while most of the bacterial isolates were sensitive to levofloxacin (94.35%). Demographic characteristics including age (p < 0.001), educational level (p < 0.001), residency (p = 0.001), and marital status (p = 0.005) were significantly associated with ASB. Lifestyle characteristics such as sexual status (p = 0.001) and frequency of washing of intimate parts after sexual intercourse (p < 0.001) were also significantly associated with ASB. Conclusion: Asymptomatic bacteriuria, particularly E. coli and Proteus spp. are prevalent in the urine of pregnant women living in Akuapem-Mampong municipality. Hence public education along with early screening of ASB is essential to reducing future risk of reproductive health complications. Future studies are required to assess the impact of public health on the rate of bacterial infections.
Asymptomatic bacteriuria can lead to urinary tract infections in as many as 20% of pregnant women. Asymptomatic bacteriuria in pregnancy can also lead to preterm births and low birth weights. The objective of this study was to profile uro-pathogens and describe the population-based prevalence, the antimicrobial sensitivity pattern, and ascertain the risk factors for asymptomatic bacteriuria among pregnant women attending the antenatal clinic of Ho Teaching Hospital, in Ghana. Urine samples were cultured, isolates identified and antibiotic sensitivity testing was done using the Clinical and Laboratory Standard Institute (CLSI) guidelines. 46 (13.7%) out of 335 pregnant women had asymptomatic bacteriuria. The most frequently isolated bacteria were Pseudomonas species (26.1%) followed by Escherichia coli (21.7%). All isolates (n=46; 100%) were resistant to Augmentin whereas 87% of the isolates (n=40) were susceptible to Gentamicin. However, most of the isolates were multi-resistant to antibiotic drugs. No education (p=0.019) and first trimester (p=0.046) of pregnancy were risk factors for asymptomatic bacteriuria. Pseudomonas aeruginosa was the most frequent organism isolated. All the uro-pathogens were resistant to Augmentin, while high rates of resistance to Tetracycline, Amikacin, Norfloxacin, and Levofloxacin were observed. The study reveals that asymptomatic bacteriuria was significantly associated with the first trimester of pregnancy and having no education.
Background
Urinary tract infection (UTI) is one of the most common bacterial infectious diseases encountered in clinical practice, and accounts for significant morbidity and high medical costs. To reduce its public health burden, there is the need for local research data to address aspects of prevention and management of UTI. The aim of this study was to investigate community-acquired UTI among adults in Accra, Ghana, including the risk factors, etiological agents, and antibiotic resistance.
Methods
This was a cross-sectional study involving 307 patients clinically diagnosed with UTI at the Korle Bu and Mamprobi polyclinics in Accra. Urine specimens were collected from the study participants and analyzed by culture, microscopy, and dipstick. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antibiotics by the Kirby Bauer method. Multidrug resistant Enterobacteriaceae isolates were screened for Extended Spectrum β-lactamase (ESBL) production by the double disc method, and isolates that tested positive were analyzed by Polymerase Chain Reaction for ESBL genes. Demographic information and clinical history of study participants were collected.
Results
Based on the criteria for laboratory confirmed UTI, 31 (10.1%) of the 307 specimens were positive and the main risk factor of UTI among the study participants was pregnancy (P=0.02, OR=2.43). The most common uropathogen isolated was Escherichia coli (48.9%), followed by Klebseilla sp. (16.1%). Prevalence of resistance was highest for Piperacillin (87.1%) and Amoxicillin+Clavulanic Acid (87.1%) and lowest for Amikacin (12.9%). Prevalence of multidrug resistance among the uropathogens was 80.1% (25) and the most common ESBL gene detected was CTX-M-15.
Conclusion
Pregnant women constitute the key risk population of UTI in Accra, while Amikacin remains a suitable drug for the treatment of febrile UTI. The high prevalence of multidrug resistance among the uropathogens highlights the need for surveillance of antimicrobial resistance among these pathogens.
Purpose: We describe the commonest pathology responsible for lower urinary tract obstruction (LUTO) and associated symptoms such as UTI, etc. among males at the Komfo Anokye Teaching Hospital (KATH) in Kumasi. Materials and Methods: Between January and December 2009, prospective cross sectional hospital based study was conducted involving 103 subjects. Patients with symptoms of LUTO and who were on short admission (up to 48 hours) at the accident and emergency unit of KATH were identified as potential study subjects. All the patients presented with acute retention of urine at the emergency unit of KATH and urethral catheterization was attempted to relieve them of the retention under sterile conditions. Those patients whose initial catheterization failed went through suprapubic cystostomy (suprapubic catheterization). Urine specimens for culture and sensitivity tests were then collected into sterile urine containers immediately after the catheterization (irrespective of type). Ultrasound Scan was requested for all the patients to assist in diagnosing enlargement of the prostate and other associated urological pathologies. Retrograde urethrogram was however, requested for those patients with suprapubic catheterization and which helped in the diagnosis of the urethral stricture. For a particular child, urethral catheter was passed under sterile condition and Micturicting Cysto-Urethrogram (MCUG) was done to assist in diagnosing posterior urethral valve and other conditions. Those subjects whose urinalysis revealed pyuria and positive urine culture and who had voluntarily agreed to enter the study were enrolled. Subjects whose urine culture had multiple bacteria growth that was deemed to be contaminants were excluded from the study. Results: The mean age for males with LUTO was 62 years. The youngest male with LUTO was aged 2 years whilst the maximum age was 93 years. LUTO due to prostatic hyperplasia was found in 79 (76.7%) men; 23 (22.3%) had LUTO due to urethral stricture and 1 (1.0%) (youngest male). The mean age of patients that had LUTO due to urethral stricture was approximately 39 years. The youngest patient with LUTO due to urethral stricture aged 22 years whilst the maximum age was 72 years. Microbiological results indicated that Escherichia coli caused 53 (51.5%) of urinary tract infection (UTI) due to LUTO; Klebsiella = 23 (22.3%); Staphylococcus aureus = 14 (14.6%); Pseudomonas spp. = 8 (7.8%) Proteus = 2 (2.0%); Citrobacter = 1 (1.0%) and Salmonella spp. =1 (1.0%). Conclusion: The most common cause of lower urinary tract obstruction (LUTO) in Kumasi, Ghana is prostatic hyperplasia and the commonest causative organism of the associated UTI symptom is Escherichia coli.
Microbiological culture examination of urine samples from 502 pregnant women attending antenatal clinic resulted in the isolation of seven genera of bacterial species. They were Staphylococcus aureus 16 (21.3%), Escherichia coli 12 (16.0%), Staphylococcus spp. 11(14.7%), Klebsiella spp. 8 (10.7%), Pseudomonas aeruginosa 7 (9.8%), Streptococcus faecalis 6 (8.0%), and Citrobacter spp. 1 (1.3%). Asymptomatic significant bacteriuria occurred in 16 (12.22%), pyuria in 10 (2.0%) while significant bacteriuria with pyuria occurred in 1(0.2%). The antibiogram indicated that ofloxacin, ciprofloxacin and nalidixic acid were in that order the most effective of the antibiotics tested. All isolates showed multiple resistance to most of the antibiotics tested. Plasmid DNA was detected in Ps. aeruginosa and E. coli with an estimated molecular weight of between 4.5 and 6.5 kb. The result indicated a significant rise in the frequency of S. aureus in asymptomatic bacteriuria.
Urinary tract infections culminating from poor diagnosis during pregnancy puts pregnant women at high risk of serious complications. This study investigated the incidence of urinary tract infections among pregnant women attending antenatal clinics in the Cape Coast Metropolis of the Central Region of Ghana. Physical, chemical, microscopic, and microbial analysis were performed on urine samples obtained from 200 pregnant women aged 15-45 years attending the University of Cape Coast Hospital, Cape Coast Metropolitan Hospital and Ewim Urban Health Centre. The prevalence of urinary tract infections in the three trimesters was determined together with sensitivity testing of the bacteria isolates to antimicrobial drugs. Overall prevalence stood at 56.5 %, although comparatively high in pregnant women in the second trimester (50.4 %). Escherichia coli were the most implicated organism (48.7 %). Pregnant women aged between 15 – 32 years were the most affected and gentamycin was the most effective antimicrobial against the bacteria isolates. Results indicated that the incidence of urinary tract infections was high among pregnant women in the study area; therefore, urine microbial screening should be included in the routine antenatal checkups for pregnant women to detect the asymptomatic infections to reduce its risk to pregnancies.
This study was carried out in order to determine the incidence of urinary tract infection in children and adolescents, identify the uro-pathogens responsible for the infection and study the antibiotic sensitivity patterns of the uro-pathogens. Clean voided mid-stream urine samples were collected in sterile universal bottles from 301 children and adolescents between the ages of 5 and 18 years at the Obafemi Awolowo University Teaching Hospital complex (OAUTHC) Ile-Ife, Nigeria from December 2005 - July 2006. Culture plates with bacteria counts greater than or equal to 1x10(5) cfu-ml(-1) were taken as positive, thus indicative of Urinary Tract Infection ( UTI). The bacteria isolates were identified based on colony morphology characteristics, Gram stain reaction and biochemical tests using API 20E kits. The identified bacteria were then tested in vitro with standard antibiotics disc to determine their antibiotics sensitivity patterns. The result of this study shows that 36 (11.96%) of the 301 patients studies had UTI. Of the 124 females examined, 28 (22.4%) had positive urine culture while 8 (4.56%) of the 177 males had significant bacteriuria. A total of 36 bacterial isolates were obtained. Escherichia coli constituted the predominant organism and was responsible for (52.77%) of the cases of UTI. This was followed by Klebsiella sp. (25%), Proteus mirabilis (13.89%), Streptococcus faecalis (5.56%) and Pseudomonas aeruginosa (2.78%). The antibiotics sensitivity test revealed a high level of resistant to cotrimoxazole, amoxicillin and colistin as more than 60% of the isolates were resistance to these. This study highlights the presence of multi-resistance P. aeruginosa and poor compliance of the pathogens in vitro to antibiotics commonly used in treating UTI. It is therefore suggested that appropriate antimicrobials be administered to reduce the risk of multiply resistance organisms developing and avert ineffectiveness of antibiotics. Prompt therapeutic intervention is also essential to prevent cases of asymptomatic UTI from becoming symptomatic with resultant damage.
Urinary tract infections culminating from poor diagnosis during pregnancy puts pregnant women at high risk of serious complications. This study investigated the incidence of urinary tract infections among pregnant women attending antenatal clinics in the Cape Coast Metropolis of the Central Region of Ghana. Physical, chemical, microscopic, and microbial analysis were performed on urine samples obtained from 200 pregnant women aged 15 -45 years attending the University of Cape Coast Hospital, Cape Coast Metropolitan Hospital and Ewim Urban Health Centre. The prevalence of urinary tract infections in the three trimesters was determined together with sensitivity testing of the bacteria isolates to antimicrobial drugs. Overall prevalence stood at 56.5 %, although comparatively high in pregnant women in the second trimester (50.4 %). Escherichia coli were the most implicated organism (48.7 %). Pregnant women aged between 15 – 32 years were the most affected and gentamycin was the most effective antimicrobial against the bacteria isolates. Results indicated that the incidence of urinary tract infections was high among pregnant women in the study area; therefore, urine microbial screening should be included in the routine antenatal checkups for pregnant women to detect the asymptomatic infections to reduce its risk to pregnancies.
Changes in the organization of health services in developing countries have led to district levels assuming more responsibility for the planning, delivery and quality of community health care. This fully up-dated new edition has been produced to help those working in the district laboratory, and those responsible for the organization and management of community laboratory services and the training of district laboratory personnel. Replacing the previous publication Medical Laboratory Manual for Tropical Countries, this book provides an up-to-date practical bench manual, taking a modern approach to the provision of a quality medical laboratory service. Reviews: Review of District Laboratory Practice in Developing Countries Part 1: 'Clear and easily understood information is provided on the clinical biochemistry of laboratory analytes and the biology of parasites … The book is probably the most comprehensive source of information available today to those who work in or need to know about laboratory services in developing countries. It can be recommended as a basic document for laboratory technicians, technologists, and medical doctors at all levels …' Bulletin of the World Health Organization.
54.3%, while in males the recorded value was 45.7%. Gram-negative isolates had a prevalence of 74.7%, while gram-positive isolates had 25.30%. The bacteria isolated in order of ranking were E. coli (24.5%), K. pneumoniae (17.3%), P. mirabilis (14.6%), S. faecalis (13.4%), S. aureus (5.3 %), P. vulgaris (4.7%), P. stuartii (4.1%), S. epidermidis (3.8%), A. faecalis (3.4%), S. saprophyticus (2.8%), P. aeruginosa (2.5%), S. marsescens (2.0%) and C. fruendii (1.7%). The highest proportion of isolates were E. coli (24.5%), K. pneumoniae (17.3%), P. mirabilis (14.6%), S. faecalis (13.4%), S. aureus (5.3%), P. vulgaris (4.7%), and P. stuartii (4.1%) accounting for 83.9% of the total number of isolates recovered from the urine samples. Other less-frequent isolates in aggregate caused 16.1% of infections. Antibiotic sensitivity and resis- tance analysis were performed by the disc diffusion method employing commercial antibiotics discs. Susceptibility of the clinical isolates to antibiotics commonly used in the 750 bed referral hospital was variable, depending on species and drug in question. The mean susceptibility of the isolates re-corded were E. coli (36.3%), K. pneumoniae (44.1%), P. mirabilis (47.8%), S. faecalis (51.3%), S. aureus (43.1 %), P. vulgaris (48.1%), P. stuartii (45.0%), S. epidermidis (49.7%), Al. faecalis (54.5%), S. saprophyticus (54.2%), P. aeruginosa (38.6%), S. marcescens (44.2%) and C. fruendii (40.4%). The mean sensitivity of the antibiotics were ofloxacin (63.8%), gentamycin (13.26%), streptomycin (37.0%), colistin (49.2%), am- picillin (25.4%), nalidixic acid (45.5%), nitrofurantoin (55.4%), augmentin (64.9%), tetracycline (27.0%), cotrimoxazole (41.8%), pefloxacin (34.9%), chloramphenicol (50.9%), and erythromycin (51.6%). The data obtained in this study highlight the problems of bacterial prevalence and resistance among uro- pathogenic bacteria in Yola, Nigeria.