Prevalence Of Bacteriuria And Antibiotic Sensitivity Profile Of Bacterial Isolates Among Sexually Active Nonpregnant Women Attending Thika Level 5 Hospital

ABSTRACT

Bacteriuria is commonly found in women and about thirty three percent (33%) of adult women have encountered an incidence of symptomatic cystitis at least once in their life time. In case the uropathogens are unidentified and management undertaken, bacteriuria may cause more dangerous and adversed complications, including nephritis and renal failure. Majority of studies done in Kenya have focused on pregnant women with no documented information available on the sexually active non pregnant women population despite a heightened risk of bacteriuria in this age group. The objectives of this study were to determine the occurrence of bacteriuria, to isolate bacterial pathogens associated with the bacteriuria, to determine antibiotic susceptibility profile on the isolated bacterial pathogens in sexually active non pregnant women attending Thika level 5 Hospital, Kiambu County, Kenya. The study employed a cross sectional design and random sampling technique. Three hundred and eighty four (384) mid-stream urine samples were collected from sexually active non pregnant women aged 18 to 48years attending Thika level 5 hospital. The urine samples were analyzed using biochemical methods. Microscopy was done to observe the presence of motile bacteria and pus cells. The positive samples were cultured on Cystine Lactose Electrolyte Deficient (CLED) media. The isolated bacterial pathogens were identified by standard bacteriological methods. Antibiotic susceptibility testing was done on the antibiotics recommended for bacteriuria by the Ministry of Health. Demographic characteristics were analyzed using simple percentages among related variables and presented using pie chart and tables. The occurrence of bacteriuria was calculated using the formulae of Le and Boen et al. (1995). The bacterial isolates and antibiotic susceptibility tests were analyzed using Pearson's Chi-square test at a confidence interval of 95%. Out of 384 urine samples tested, 311(81%) samples had significant growth (P=0.001) and 73(19%) had no growth (P=0.056). The frequency of the study population was high within age group 18-27 years with (46.88%).The distribution of bacteriuria within age groups was highest in age group 18-27 years with (45.31%, P= 0.001). This study showed decrease of bacteriuria with increasing age (P=0.001). Escherichia coli was the most isolated bacterial pathogen (41.5%). Escherichia coli and Staphylococcus saprophyticus pathogens were isolated in all age groups. Among the ten antibiotics tested, bacterial isolates were sensitive to Cefuroxime at 93.2% (χ 2=29.809, P=0.001) and resistant to ceftazidime at 89.7% (χ 2 =62.791, P=0.001). The most sensitive bacterial isolate was P. mirabilis and the most resistant was P. aeruginosa. This study recommended that, since antibiotic resistance among the uropathogens is evolving problem, a routine surveillance to monitor the etiologic agents of bacteriuria and the resistance pattern should be carried out timely to choose the most effective empirical treatment by the physicians. Data obtained from this study is important in appropriate management and treatment of bacteriuria. This will help in proper prescription of the appropriate antibiotic for the treatment of bacteriuria.