Prevalence and Antibiotic Resistance Patterns of Gram-Negative Uropathogens among Paediatric Patients in Nigeria

Objective: This study aimed to detect and compare the frequency and antibiotics resistant pattern of Gram-negative uropathogens implicated in urinary tract infections (UTIs) in paediatric patients attending some hospitals in Nigeria and to proffer recommendations for its management. Methods: Based on standard procedures, midstream urine samples were collected. Urinalysis was done as a preliminary diagnosis of UTI using Combi-9 test strip. Isolation of uropathogen was done and antibiotic sensitivity test was carried out using Kirby-Bauer technique. Results: Out of 489 samples collected, 130 (26.4%) was positive for UTI. The prevalence rate of UTI in the investigated areas such as Nsukka, Otukpo, Gboko and Kastina Ala was 31.8%, 17.5%, 34.3% and 17.1%, respectively. The prevalence of UTI was higher in males 81 (30.9%) than in females 49 (21.6%), but there was no statistically significant association between gender and UTI (p = 0.636). The prevalence of UTI was greater among the age of 2 - 5 years (28.2%) and decreased with the increase in age, although there was no significant association between UTI and the age groups (p = 0.870). Generally, Klebsiella pneumonae (88.8%) was the most dominant bacterium (it was even more in males), followed by E. coli (40.6%), which was more in females, then Pseudomonas spp. (45.0%) and Proteus mirabilis (13.8%). The in-vitro antibiotic susceptibility testing shows that the isolate was highly resistant to Augmentin, Cotrimoxazoel, Amoxicilin and Tetracycline, while some of the isolate shows intermediate resistant to Nitrofurantoin and Nalixidic acid. Ofloxacine and Gentamicin were the most effective antibiotics against the isolates from all the study areas. The isolates had a varied range of MICs and MBCs. Conclusion: K. pneumonia predominated all isolates. The resistant patterns of the isolates to some of the antibiotics show that the first line of antibiotics for treatment of UTI in children in these areas is Ofloxacine and Gentamicin.

Prevalence of Urinary Tract Infections and Associated Risk Factors among Pregnant Women in Enugu Metropolis, Nigeria

The prevalence of Urinary Tract Infections (UTI) among pregnant women was carried out in the Department of Obstetrics and Gynaecology of five (5) different hospitals in Enugu metropolis. Four hundred and eighty (480) pregnant women whose ages ranged from 20 - 40 years were recruited in this study using a well-designed questionnaire by random sampling technique. The subsidiary sample size included twenty (20) obstetricians working in these hospitals. Prevalence of UTI in the present study was affected by several factors namely;age, gestational age, socio-economic status, increased number of pregnancies or parity, untreated previous UTI history, diabetes, hypertension, and lack of personal hygiene. A total of 384 urine samples were collected from these pregnant women that attended antenatal care at the different hospitals for four (4) months. The urine samples were cultured and of the 384 urine samples analyzed, the following organisms were isolated;E. coli (89) (40.6%), Staphylococcus aureus (62) (28.3%), Klebsiella pneumoniae (36) (16.4%), and Pseudomonas aeruginosa (18) (8.2%). Others were Enterococcus sp. (8) (3.6%), Enterobacter sp. (4) (1.8%), and Proteus sp. (2) (0.9%) UTI was most prevalent among women of age category 36 - 40 years and the frequency was more in the third-trimester pregnancies. Early diagnosis and treatment of UTIs during pregnancy can ensure the safety of the mother and the foetus. There is also a need for continuous health education during antenatal visits to boost physical and environmental hygiene.