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African Journal of Biomedical Research
Ibadan Biomedical Communications Group
ISSN: 1119-5096
Vol. 9, No. 3, 2006, pp. 141-148
Bioline Code: md06025
Full paper language: English
Document type: Research Article
Document available free of charge

African Journal of Biomedical Research, Vol. 9, No. 3, 2006, pp. 141-148

 en Catheter Associated Urinary Tract Infection: Aetiologic Agents and Antimicrobial Susceptibility Pattern in Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria
Taiwo, S.S. & Aderounmu, A.O.A.

Abstract

The objective of this study was to identify microbial pathogens associated with bacteriuria and UTI in patients with indwelling urethral catheters and determine their susceptibility patterns to commonly used antimicrobial agents in our institution. Catheter urine and catheter tip specimens of all the patients were analyzed by microscopy and culture on Blood, MacConkey and CLED agar plates. Pure colonies of isolated organism were biochemically characterized and disc diffusion antibiotic susceptibility was performed on each bacterial isolate. The commonest indication for catheterization is benign prostatic hyperplasia (BPH, 62.3%). One hundred and eight patients (88.5%) were urine culture positive for microbial pathogens with 126 microbial isolates while 14 (11.5%) were bacteriologically sterile. Ninety two of those positive (85.1%) each had one organism recovered, 14 (13.0%) had two organisms recovered and 2 (1.9%) had 3 organisms recovered. Klebsiella check for this species in other resources spp were the commonest pathogen isolated with 46 (36.6%), followed by Pseudomonas check for this species in other resources spp 34 (27.0%), Escherichia coli check for this species in other resources 26 (20.6%), Staphylococcus aureus check for this species in other resources 12 (9.5%), Proteus mirabilis check for this species in other resources 4 (3.2%), Candida albicans check for this species in other resources 4 (3.2%) and coagulase negative staphylococci 2 (1.6%). The in vitro antibiotic susceptibility pattern of the Gram negative organisms showed high resistance to commonly used antibiotics such as ampicillin (100%), gentamicin (90.9%), tetracycline (89.1%), cotrimoxazole (87.3%), cefuroxime (81.1%), nalidixic acid (87.3%), nitrofurantoin (67.3%), colistin (63.7%), perfloxacin (65.5%) and ciprofloxacin (56.4%). Staphylococcus aureus isolates were also resistant to penicillin (100%), gentamicin (100%), cotrimoxazole (100%), chloramphenicol (100%), cloxacillin (83.3%), tetracycline (83.3%), erythromycin (66.7%) and cefuroxime (66.7%). Only perfloxacin (66.7% sensitivity) and ciprofloxacin (83.3% sensitivity) appear effective. We conclude that catheter-associated UTI in our institution is caused by multi-resistant microbial pathogens which has occurred consequent on prophylactic antibiotic therapy administered after catheterization. Emphasis should be placed on good catheter management rather than the use of prophylaxis, to reduce the incidence of catheter associated UTI.

Keywords
Catheter, UTI, multi-resistant, pathogen

 
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