Project Materials

PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY OF GRAM NEGATIVE BACTERIA IN THE URINE OF CARITAS UNIVERSITY STUDENTS

ABSTRACT

To determine the prevalence and sensitivity pattern of urinary pathogens, 60 midstream urine samples from Caritas University students were analysed utilising cultural methods. The samples were inspected under a microscope and cultivated on blood agar and Macckonkey agar. The disc diffusion method was utilised for antibiotic testing. Of the 60 urine samples, 48 showed considerable increase, with an 80% prevalence rate. Females were found to be more contaminated than men, with prevalence rates of 56.70% and 43.30%, respectively, between the ages of 18 and 25 years. Escherichia coli was the most prevalent. The isolates were most sensitive to Gentamycin, Nitrofurantoin, and Ofloxacin, whereas the most resistant were Tetracycline, Cortrimozol, Cephalexin, and Ampicillin. As a result, the study strongly advised the use of Nitrofurantoin, Gentamycin, and Ofloxacin for the treatment of UTIs.

Chapter one

INTRODUCTION

Gram-negative bacteria lose their crystal violet pigment during the gramme staining technique. They are distinguished by their cell wall composition.

Gram-negative bacteria display the following characteristics: The cytoplasmic membrane Thin peptidoglycan layer (far thinner than gram-positive) Outer membrane containing lipopolysaccharide outside the peptidoglycan layer.

Porin exists in the outer membrane and works like pores. The area between the layer of peptidoglycan and the secondary cell membrane is called the periplasmic space.

If flagella are present, they have four (4) supporting rings rather than two. No techoic acid or lipopolysaccharide. Gram-negative bacteria include Escherichia coli, Salmonella, Pseudomonas, Klebsiella, Proteus, Helicobacter, Mosoxella, Cyanobacteria, and Spirochetes species.

They also cause serious urinary tract infections in various regions of the world. Appropriate antimicrobial therapies are frequently crucial in reducing morbidity and death in hospitalised patients with pathogen-related illnesses. Gram-negative bacteria are non-spore-forming bacilli that grow quickly on standard laboratory media in both aerobic and anaerobic settings.

It is estimated that symptomatic urinary tract infections (UTI) account for up to 7 million emergency department visits and 100,000 hospitalisations per year. UTIs are the most prevalent hospital-acquired infections, accounting for up to 35% of nosocomial infections.

It is the second leading cause of bacteraemia in hospitalised patients (Nacem, 2000). UTI is known to occur in all groups, however it is especially prevalent in females of all ages and males at both ends of life, immunocompromised patients, and anyone with functional or anatomical abnormalities of the urinary and excretory systems.

UTI is defined as the microbial invasion of any urinary tract tissue from the renal cortex to the urethrameatus (Nicolle, 2000). It is also known that a single bacterial strain in the urinary tract can have more than 100 rods (105) organisms per ml in two consecutive urine samples.

UTI can be categorised as climbing or declining. Infections restricted to the urethra or bladder are called ascending uretitis or cystitis, respectively. On the other hand, germs travel from one or more contaminated bodily sites to the kidney, then down the ureter to the bladder.

Such descending UTIs produce serious kidney infection, known as pyelonephritis (Parsons 1958). This is potentially more problematic; infections of the urethra are known as urethritis, while infections of the prostrate gland are known as prostitis.

This classification is based on the presence or lack of symptoms, recurrence, and the presence or absence of complicating factors, which are host variables that facilitate the creation and maintenance of bacteraemia or worsen the prognosis of UTIs involving the kidney.

The majority of infections are gram-negative species, with Enterobacteriace being the most common (Neu, 1992). Although Escherichia coli is the most common cause of urinary tract infections in young women, other gram-negative rods including Proteus species and Pseudomonas aeruginosa, an aerobic rod, can also cause problems.

Because of its resistance to antimicrobial medication, this urinary tract pathogen is difficult to treat successfully. Antibiotics are used to control bacterial illnesses in humans.

Gram-negative bacteria are generally sensitive to numerous antimicrobial treatments, however strains from different patients and carriers exhibit varying patterns and degrees of sensitivity to different medications. Increased antibiotic resistance in bacterial pathogens is a global concern.

The prevalence of antimicrobial resistance among urinary tract infectious agents is also increasing (Mathai et al. 2001; Karaloswsky et al. 2001), and treatment has become more complicated as a result of increasing resistance and empirical therapy, which leads to treatment failures in the majority of cases associated with gram-negative bacteria (Blondeau et al. 1999).

The current study studied the pattern of gram-negative uropathogens and their antimicrobial resistance pattern among clinical isolates to commercially available antibiotics that are frequently administered in urinary tract infection cases.

1.1 Aims and Objectives

1. To determine the prevalence of gram-negative organisms in the urinary system among Caritas University students.

2. To explore their antibiotic sensitivity pattern in order to develop treatments for urinary tract infections in our community.

3. Determine the age and sex prevalence. To evaluate the incidence of bacterial strains and their antimicrobial susceptibility in urine.

4. To identify the pathogenic microorganisms most usually associated with UTI and susceptibility patterns, physicians will be able to select the most appropriate empirical treatment.