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Asymptomatic Bacteriuria Amongst the Inhabitants of Okigwe, Imo State Nigeria

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Asymptomatic Bacteriuria Amongst the Inhabitants of Okigwe, Imo State Nigeria Nigerian Journal of Microbiology, Vol. 22(1): 16 30 – 1633 2008 Asymptomatic Bacteriuria Amongst the Inhabitants of Okigwe, Imo State Nigeria *Ugbogu, O.C and Enya, V. N Department of Microbiology, Abia State University, Uturu, Nigeria. Abstract The prevalence of asymptomatic bacteriuria amongst the inhabitants of Okigwe was investigated using culture techniques. The predominant bacteria isolated were Escherichia coli , Staphylococcus aureus , Klebsiella species, Pseudomonas aeruginosa and Proteus species. Out of the 120 urine samples examined 20.8% had asymptomatic bacteriuria. The percentage prevalence was 17.7% and 22.5% for males and females examined respectively. Escherichia coli was the most prevalent occurring in 18.2% of the samples while Klebsiella species and Proteus species that both occurred in 5% of the positive samples were the least. Traders were more affected than students and civil servants. There is need to encourage people to screen for asymptomatic bacteriuria in other to avert the consequences of the subsequent complications. Keywords: bacteriuria, occupation, prevalence, symptom. *Corresponding author; E-mail; [email protected] phone 07084159395 Introduction Materials and methods Normally urine and the urinary tract Population studied : above the entrance to the bladder are essentially The population for this study was a free of microorganisms (Nester et al ., 2004). randomly selected group of 120 aparently Bacteriuria is a condition in which bacteria are healthy individuals that were either students, present in urine. Asymptomatic bacteriuria is traders or civil servants in Okigwe. The study defined as significant bacteriuria when growth of population were of various age groups ranging ≥ 10 5 cfu/ml of freshly voided urine (Umeh et from 16 to 45 years. The aim of the study was al ., 2006; Uwaezuoke and Ogbulie, 2006). explained to volunteers and other information Bacteriuria affects all age groups but women are such as age and occupation were ascertained. more susceptible than men due to short urethra, Women menstruating at the time of collection absence of prostatic secretion, pregnancy and were not included in the study. easy contamination of the urinary tract with faecal flora (Al- Haddad, 2005). Untreated Collection of specimens and microbiological asymptomatic bacteriuria is a common cause of examination : both major and minor diseases which may Mid stream clean catch urine were sometimes be unresponsive to treatment. collected in sterile disposable universal bottles Asymptomatic bacteriuria particularly during and examined by the methods of Collin et al., pregnancy has been associated with acute (1989) . A loopful of 5mm wide standard wire pyelonephritis, foetal growth restriction and still containing 0.005ml of urine (Umeh et al.,2006) birth (Amadi et al .,2007). Untreated was inoculated on Mac Conkey agar plate asymptomatic bacteriuria leads to development (Fluka),blood agar, Eosin Methylene Blue of cystitis in approximately 30% of the cases agar(EMB) (Britania) and Cysteine Lactose (Kassa, 1980; Gilstreap et al ., 1981). Electrolyte Deficient agar (CLED). The plates Although asymptomatic bacteriuria may were incubated aerobically for 24h at 37 oC. Only not require treatment because the bacteria may plates that gave counts ≥ 10 5 cfu/ ml were not be causing harm, certain groups of people considered to have significant growth. Pure such as pregnant women and their unborn cultures of each isolate was used for further fetuses may be at risk of complications (Amadi identification. et al ., 2007) and can give rise to infection of the Identification of isolates : kidney or other parts of the urinary tract . This The isolates were identified by Gram paper reports the prevalence of asymptomatic reaction, motility test, catalase, oxidase, bacteriuria amongst the inhabitants of Okigwe. coagulase, indole, methyl red, Voges-prausker, 1630 Ugbogu and Enya 2008 Nig. J. Microbiol. 22(1): 1625 – 1629 2008 citrate utilization, H 2S production, urease test isolated were Escherichia coli , Pseudomonas and growth on Kliger's iron agar (Baron et al ., aeruginosa, Staphylococcus aureus, Klebsiella 1990; Cheesbrough, 2000). species and Proteus species. Except Results Pseudomonas aeruginosa observed in this study, Out of the 120 specimens examined 25 the organisms isolated have been reported by (20.8) had asymptomatic bacteriuria. Out of the other studies conducted in Nigeria (Umeh et al., male population of 49, 9(17.7%) had 2006; Uwaezuoke and Ogbulie, 2006). asymptomatic bacteriuria while 16(22.5%) out Escherichia coli was the most prevalent in this of 71 females examined had asymptomatic study and accunted for 18.2% of the isolates bacteriuria (Table 1). The highest percentage followed by Staphylococcus aureus . This finding occurrence (33.3%) was amongst the age group agrees with the work of Uwaezuoke and Ogbulie 26-30, followed by the age group 21-25 (26.3%) (2006) but does not agree with the findings of while the age group 41-45 had the least Umeh et al., (2006) that reported Staphylococcus prevalence of 11.1% (Table 2). Traders were aureus as the most prevalent organism. Our mostly affected than students and civil servants finding also does not agree wth that of Amadi et (Table 3). The bacteria isolated from the urine al .,(2007) that reported the trend S.aureus, E. samples examined were Escherichia coli, coli and Klebsiella species amongst pregnant Pseudomonas aeruginosa, Klebsiella species, women in Abakiliki, Nigeria. Staphylococcus aureus and Proteus species. The Traders were found to have the highest most frequently isolated bacteria was prevalence rate (32.5%) compared to students Escherichia coli (18.2%) while the least was and civil servants. This high frequency of Klebsiella species and Proteus species that were asymptomatic bacteriuria amongst the traders isolated in 5% of the samples respectively could be attributed to high level of illiteracy (Table 4). amongst this group and ignorance of proper Discussion hygiene practices. Umeh et al ., (2006) observed The prevalence of 20.8% was observed that toilet habits in the manner of buttocks in the study population, this is within the same cleaning after defaecation appeared to be one of range (23%) reported by Umeh et al.,(2006). the predisposing factors to bacteriuria. Earlier studies reported lower prevalence rates in Females were mostly affected than men in this healthy populations (Perez and Ferrer, 2004; study with a prevalence rate of 22.5% compared Uwaezuoke and Ogbulie, 2006). The organisms Table 1: Prevalence of Asymptomatic bacteriuria in Okigwe Sex Number Examined Number affected Males 49 9 (17.7) Females 71 16 (22.5) Total 120 25 (20.8) Numbers in brackets are percentages. Table 2: Age distribution of asymptomatic bacteriuria in Okigwe Age group Number Examined Number affected 16-20 21 4(19) 21-25 19 5(26.3) 26-30 21 7(33.3) 31-35 22 4(18.1) 36-40 19 3 (15.7) 41-45 18 2 (11.1) Numbers in brackets are percentages 1631 Ugbogu and Enya 2008 Nig. J. Microbiol. 22(1): 1630 – 1633 Table 3: Prevalence of asymptomatic bacteriuria in Okigwe by Occupation Occupation Number Examined Number Affected Students 50 8(16) Traders 40 13(32.5) Civil Servants 30 4(13.3) Numbers in brackets are percentages Table 4: Percentage occurrence of bacterial isolates Organism Percentage Occurrence Escherichia coli 18.2 Pseudomonas aeruginosa 6.7 Klebsiella spp 5.0 Staphylococcus aureus 12.5 Proteus spp 5.0 to 17.7% in men. This higher prevalence in Azubuike, C.N., Nwamadu, O.J., Oji, R.U and females could be as a result of urethral Uzoije, N (1994) Prevalence of Urinary contamination which is higher in females than Tract Infection among school children in a Nigerian rural community. West African males because of anatomical position of the Journal Medicine. 13:48-52 female urinogenital tract(Ojo et al ., 2007; Baron, E.J; Peterson, L.R and Finegold, S.M Azubuike et al .,1994). Moreso the pressure (1990) Bailey and Scott’s Diagnostic which goes with coitus may permit the Microbiology 9th edition. Mosby- Year introduction of organisms from introtus into the Book Inc Baltimore 958pp. urinary tract of females (Umeh et al .,2006; Cheesbrough, M (2002) District Laboratory Valiquett, 2001). practice in tropical countries Part 2: Cambridge University Press Uk 391pp References Collins, C.H; Lyne P.M and Grange, J.M (1989) Akerele, J ., Abhulimen, P and Okonofua F Microbiological methods 6th edition (2001) Prevalence of Asymptomatic Butterworth and Co Publishers ltd London bacteriuria among pregnant women in 405pp. Benin City, Nigeria. Journal of Obstetrics Gilstreap, L.C; Leveno, K.J and Cunningham, and Gynaecology 21: 141-144 F.G (1981) Renal infection and Pregnancy Al-Haddad, A.M (2005) Urinary tract infection outcome. American Journal of Obstetrics among pregnant women in Al-Mukalla and Gynaecology 141: 709-716. district Yemen. Eastern Medittedanean Kass, E.H (1980) Pregnancy, Pyelonephritis and Health Journal 11: 505-510 prematurity. Clinical Obstetrics and Amadi, E.S; Enemuo, O.B; Uneke, J.C; Nwosu, Gynaecology 13 : 239-254. O.K; Onyeagba, R.A and Ugbogu, O.C Nester M.T; Harley D; Pearsall N.N; Roberts (2007) Asymptomatic bacteriuria among E.C; Anderson, D.G and Nester, W.G women in Abakiliki Ebonyi State, Nigeria. (2004) Microbiology: A human Journal of Medical Sciences 7: 698-700. perspective 4th edition McGraw-Hill Higher education Boston 817pp 1632 Ugbogu and Enya 2008 Nig. J. Microbiol. 22(1): 1630 – 1633 Ojo, D.A; Akpan, I and Mafiana, C.F (2007) asymptomatic bacteriuria in a rural Prevalence of asymptomatic and community in Benue State, Nigeria. symptomatic urinary tract infection in a Nigerian Journal of Microbiology 20: Nigerian community. Nigerian Journal of 873- 879 Microbiology 21 :1510-1517 Uwaezuoke, J.C and Ogbulie, J.N (2006) Perez, J.A and Ferrez J.F (2004) Asymptomatic Asymptomatic Bacteriuria amongst school bacteriuria in women. Epidemiological girls in Owerri, Nigeria. Nigerian Journal pathologic and therapeutic study. Arch. of Microbiology 20: 880-885 Exp.
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