Identification and Antibiotic Resistance Profile of Uropathogenic Bacteria from Sexually Active Women with Bacterial Vaginosis

Background: Urinary tract infections (UTIs) in women with bacterial vaginosis (BV) continue to pose tremendous health concerns and require appropriate use of antibiotics for effective case management. This study determined the prevalence, etiology and antibiotic resistance profile of uropathogenic bacteria isolated from sexually active women with BV in Lagos Nigeria. Method: A total of 258 sexually active women presenting with gynaecological complaints at the maternal and child unit of twenty Primary Health Care Centres in Lagos Nigeria from May 2017 to March 2018 were consecutively enrolled with consent. Bacterial vaginosis was diagnosed based on Amsel criteria. Midstream urine samples were collected aseptically, analyzed for bacterial pathogens and antibiotic susceptibility using standard microbiological methods. Results: BV was diagnosed in 184 (71.3%) with 69.2% also having UTI. Ninety four (36.4%) had UTI predominantly caused by Gram negative bacteria (96.8%). The organisms isolated were Escherichia coli 79 (84.0%), Klebsiella pneumoniae 5 (5.3%), Pseudomonas aeruginosa 4 (4.3%), Proteus mirabilis 3 (3.2%) and Staphylococcus saprophyticus 3 (3.2%). The pathogens elicited high resistance (66.7% - 100%) to tetracycline, amoxicillin-clavulanic acid, nitrofurantoin and cephalosporins, and moderate resistance (50%) to ofloxacin by P. aeruginosa strains. The isolates were susceptible (100%) to piperacillin-tazobactam and meropenem. Multi-drug resistance (MDR) was observed among 97.8% of the bacteria isolated. Conclusion: Findings from this study indicate high occurrence of UTI caused by MDR pathogens among sexually active women with BV with emerging evidence of poor clinical utility of nitrofurantoin and other commonly used first-line antibiotics against UTI. Further studies on non-bacterial aetiology of BV, molecular characterization of S. saprophyticus and Gram Negative Bacteria UTI are recommended.

Uropathogens and diagnostic potential of pH and specific gravity in a rural community of Nigeria

Objective:To assess the association between urine pH and specific gravity(SG)and occurrence of urinary tract pathogens involved in urinary tract infection(UTI)in school pupils.Methods:Laboratory culture techniques and biochemical tests were carried out to identify the UTI-associated bacteria in school pupils’urine of United Nursery and Primary School,Ilara-Remo,in Ikenne Local Government area,Ogun State,Nigeria.Urine dip-stick tests were carried out on the samples to take pH and SG measurements.Results:The prevalence of urinary tract pathogens in the study population was 82.4%.This prevalence was not gender and age dependent(P>0.05).Escherichia coli(E.coli)(37.0%)and Klebsiella(0.9%)were the highest and least prevalent uropathogens.There was significant increase in proportion of subjects diagnosed with E.coli(37.5%),Staphylococcus aureus(32.0%),Klebsiella(57.1%)in pH 9,pH 6 and pH 8,respectively(P<0.05).However,an increase in proportion of individuals diagnosed with Proteus occurred in pH 6 and 9(31.3%each);these proportions were not significant compared with results in other pH categories(P>0.05).There were significant increase in proportion of subjects diagnosed with E.coli(50.0%),Proteus(56.3%),Staphylococcus aureus(44.0%),Klebsiella(71.4%)in SG 1.010,1.015,1.015 and 1.010,respectively(P<0.05).Conclusion:Therefore,the urine pH 9 and SG 1.010-1.015 are the best diagnostic indicators of UTI-associated uropathogens in school children.