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PROJECT TOPIC- ISOLATE AND CHARACTERIZE THE ORGANISMS CAUSING URINARY TRACT INFECTION AND TO DETERMINE THE ANTIBIOTIC SENSITIVITY PATTERNS OF THESE BACTERIA IN PATIENTS PRESENTING WITH URINARY TRACT INFECTION, IN FEDERAL TEACHING HOSPITAL ABAKALIKI (FMC)

PROJECT TOPIC- ISOLATE AND CHARACTERIZE THE ORGANISMS CAUSING URINARY TRACT INFECTION AND TO DETERMINE THE ANTIBIOTIC SENSITIVITY PATTERNS OF THESE BACTERIA IN PATIENTS PRESENTING WITH URINARY TRACT INFECTION, IN FEDERAL TEACHING HOSPITAL ABAKALIKI (FMC)

CHAPTER ONE

  • INTRODUCTION

Urinary tract infection is defined as multiplication of organisms in the urinary tract. It could be described as ascending infection involving urinary tract. It is the commonest bacterial infection managed in general medical practices (Chang et al., 2006). Urinary tract infections (UTIs) are one of the most prevalent extra-intestinal bacterial infections. Nowadays, it affects people of all ages from the neonate to geriatric age group worldwide (Akortha and Ibadin, 2008), about 150 million people are diagnosed with UTI each year (El-Sweih et al., 2008).

These infections can be divided into four very broad categories; (i) acute uncomplicated lower tract infection in women, (ii) recurrent uncomplicated lower tract infection in women, (iii) acute upper tract infection (Pyelonephritis) in women,   and (iv) UTIs in children, men and geriatric patients (George et al., 2012). Most infections are caused by retrograde ascent of bacteria from the faecal flora via the urethra to the bladder and kidney especially in the females who have a shorter and wider urethra which allows more the transfers of micro organisms (Dlekema et al., 2004).

The anatomical structure of the females’ urethra and vagina makes it susceptible to trauma during sexual intercourse as well as bacteria been massaged up the Urethra and into the bladder during pregnancy and or childbirth (El-Sweih et al., 2008). Majority of UTIs are not life threatening and do not cause any irreversible damage (Kim et al., 2006). However, when   the   kidneys   are   involved,   there   is   a   risk   of bacteriamia (Tenever and McGowan, 1996).

Urinary tract infections are some of the most common infections experienced by humans exceeding in frequency among the ambulatory patients only by respiratory and gastrointestinal infections. In women, bacterial cystitis is the most common bacterial infection. It is also the most common cause of nosocomial infections in adults. Urinary tract infection is said to exist when pathogenic micro-organisms are detected in the urine, urethra, bladder, kidney or prostate with or without the presence of specific symptoms.

In most instances, growth of more than 105 organisms per milliliter of a properly collected midstream “clean-catch” urine sample, indicates infection (Cowan and Steel, 2002). However, when significant bacteria are lacking in some cases of true UTI, especially in symptomatic patients, a smaller number of bacteria (102 to 104/ml) may signify infection. In urine specimens obtained by suprapubic aspiration or in-and out catheterization and in samples from a patient with an indwelling catheter, colony counts of 102 to 104/ml of urine generally indicate infection, conversely colony counts of >105/mI of mid stream urine are occasional due to specimen contamination.

The vast majority of uncomplicated UTIs are caused by the gram negative bacillus, Escherichia coli, with other pathogens including Enterococci, Staphylococcus, Klebsiella spp., and Proteus mirabilis (Kulkarni et al., 2014). Nowadays, drug resistance is a huge growing problem in treating infectious diseases like malaria, tuberculosis, diarrhea diseases, urinary tract infections (UTIs) etc. The improper and uncontrolled use of many antibiotics results in the occurrence of antimicrobial resistance, which becomes a major health problem worldwide (Wright, 2010).

The term antibiotic is a substance of biological origin which is antagonistic to microorganisms and its action “is against microorganisms. Originally it was considered as a chemical produced by one micro organism which can kill or inhibit the growth and survival of another microorganism (Muto et al., 2003). Antibiotics are chiefly prescribed for the treatment and control of disease causing microorganisms or germs.

Antibiotics differ a great deal in their chemistry, mode of action, and spectrum of activity. Some have been found to be active against some microorganisms while the others are not. Some microorganisms gain resistance to some antibiotic drugs during the course of treatment. Microorganisms can develop drug resistance to antibiotics by producing enzymes capable of altering the actual characteristics of the drug; the selective permeability of cell walls and membranes, the sensitivity of affected enzymes and production of a competitive substrate (Santosh and Nilima, 2011).

Unnecessary exposure to antibiotics results in resistance to antibiotics by infective agents. In other words, abuse of antibiotics leads to microbial resistance (Olorunmola et al., 2013). In patients with suspected UTI, antibiotic treatment is usually started empirically, before urine culture results are available. To ensure appropriate treatment, knowledge of the organisms that cause UTI and their antibiotic susceptibility is mandatory, as both temporary and local variables can modify these data.

They need to be constantly reevaluated to achieve a maximal clinical response before the antibiotic susceptibility of the isolate is known. The aim of this is to assess the changing susceptibility of urinary pathogens to antimicrobial agent. The following are identified risk factors to urinary track infection; Sex, Age, Occupation, Pregnancy, Obstruction, uropathy, Indwelling urinary catheter,   Poor hygiene, Antibiotics abuse, Immune suppression and Renal impairment (Kunin et al.,1994).

PROJECT TOPIC- ISOLATE AND CHARACTERIZE THE ORGANISMS CAUSING URINARY TRACT INFECTION AND TO DETERMINE THE ANTIBIOTIC SENSITIVITY PATTERNS OF THESE BACTERIA IN PATIENTS PRESENTING WITH URINARY TRACT INFECTION, IN FEDERAL TEACHING HOSPITAL ABAKALIKI (FMC)

1.1 Statement of Problem

The ever increasing number of patients presenting with urinary tract infection and the number of relapse cases of urinary tract infections after treatment in this part of the country, have resulted in this research being carried out, with a view to addressing this over increasing antibiotic resistance to organisms causing UTIs.

1.2 General Aim of the work

The general aim of this work is to isolate and characterize the organisms causing urinary tract infection and to determine the antibiotic sensitivity patterns of these bacteria in patients presenting with urinary tract infection, in Federal Teaching Hospital Abakaliki (FMC).

1.3 Specific Objectives;

  1. To isolate and characterize bacterial causing urinary tract infection in patients presenting with UTI in Federal Teaching Hospital Abakaliki (FMC).
  2. To determine their sensitivity pattern to commonly used antibiotics.

To adopt measures which will effectively reduce the ever increasing resistance of these   organisms   to   commonly used antibiotics.

PROJECT TOPIC- ISOLATE AND CHARACTERIZE THE ORGANISMS CAUSING URINARY TRACT INFECTION AND TO DETERMINE THE ANTIBIOTIC SENSITIVITY PATTERNS OF THESE BACTERIA IN PATIENTS PRESENTING WITH URINARY TRACT INFECTION, IN FEDERAL TEACHING HOSPITAL ABAKALIKI (FMC)

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