ANTIBIOGRAM OF ESCHERICHIA COLI IN URINE SAMPLES OF OUT-PATIENT FROM ST. MARY’S HOSPITAL URUA AKPAN

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ABSTRACT
The antibiogram of Escherichia coli in urine samples of out patients from St. Mary’s Hospital Urua Akpan was carried out using standard analytical procedures. The result obtained shows the infection rate of Escherichia coli to be higher in female (68.42%) than in male (31.58%) especially between the age bracket of 21-40 years. The antibiotic susceptibility profile of Escherichia coli isolated from the urine samples reveals that Escherichia coli was susceptible to reflacin (28mm), tarivid acid (26mm). ciproflox (25mm), streptomycin (20mm) and gentamycin (18mm) while it was highly resistant to augmentin (5mm), amplicin (7mm), septrin (8mm), nalidoxic acid (8mm) and ceporex (11mm). From this research, it can be concluded that the high infection rate as observed in female is as a result of the female physiology and anatomy, also Escherichia coli exhibited multidrug resistance (MDR).

LIST OF TABLES
Pages
Table 4.1: The Age and Gender Distribution of Escherichia coli
Isolated from Urine Samples of Out-Patients
from St. Mary’s Hospital Urua Akpan, Aks – – 27

Table 4.2: The percentage frequency Occurrence of
Escherichia coli Isolated from urine samples – – 28

Table 4.3: The morphology and Biochemical Characteristic of
Escherichia coli from the urine samples – – 29

Table 4.4: The antibiotic sensitivity of Escherichia coli
Isolated from Urine Samples – – – – 30

TABLE OF CONTENTS
PAGES
Title Page – – – – – – – – i
Certification – – – – – – ii
Dedication – – – – – – – iii
Acknowledgement – – – – – – – iv-v
Abstract – – – – – – – – vi
List of Tables – – – – – – – vii
Table of Contents – – – – – – – viii-x

CHAPTER ONE
1.0 Introduction – – – – – 1
1.1 Background of the Study – – – – – 1-4
1.2 Aim of the Study – – – – – – 4
1.3 Scope and Limitation of the Study – – – 5

CHAPTER TWO
2.0 Literature Review – – – – – – 6-7
2.1 Physiology of Urine – – – – – 7-8
2.2 Possible Pathogens in Urine – – – – 8-9
2.3 Urinary Tract Infection (UTIs) – – – – 9-10
2.4.1 Risk Factors of UTIs – – – – – 11
2.4.2 Pathogenesis – – – – – – – 11
2.4.3 Sign and Symptoms of Urinary Tract
Infection (UTI) – – – – – – 12
2.5 Role in Disease – – – – – – 12-14
2.5.1 Prevention and Treatment of UTIs – – – 14
2.6 Antibiotic Susceptibility Pattern – – – 15

CHAPTER THREE
3.0 Materials and Method – – – – – 16
3.1 Collection of Samples – – – – – 16
3.2 Sterilization of Materials – – – – – 16-17
3.3 Cultivation of Bacteria – – – – – 17
3.4 Isolation and Purification of Isolates – – – 17-18
3.5 Gram Reaction – – – – – – 18-19
3.6 Biochemical Tests – – – – – – 19
3.6.1 Catalase Test – – – – – – 19
3.6.2 Indole Test – – – – – – – 20
3.6.3 Methyl Red-Voges Proskauer (MR. VP) – – 20-21
2.6.4 Motility Test – – – – – – 21
3.6.5 Citrate Test – – – – – – – 22
3.6.6 Urease Test – – – – – – – 22-23
3.6.7 Hydrogen Sulphide Test – – – – – 23
3.6.8 Oxidase Test – – – – – – 23
3.6.9 Sugar Fermentation Test – – – – – 23-24
3.6.10 Antibiotic Sensitivity Test – – – – 24-25

CHAPTER FOUR
4.0 Result and Discussion – – – – – 26
4.1 Results – – – – – – – 26-30
4.2. Discussion of Results. – – – – – 31-33

CHAPTER FIVE
5.0 Summary, Conclusion and Recommendations – 34
5.1 Summary – – – – – – – 34
5.2 Conclusion – – – – – – – 35
5.3 Recommendations – – – – – – 35-36
References

CHAPTER ONE

1.0 Introduction

1.1 Background of the Study
Escherichia coli is the most widely studied prokaryotic model organism and on important species in the field of biotechnology and microbiology (Tortora, 2010).
It is a common inhabitant of the human and animal gut but can also be found in water, soil and vegetable. Escherichia coli is Gram-negative facultative anaerobic rod shaped bacterium that is commonly found in human fecal flora, usually it inhabit the colon as an innocuous commensally, but some serotype can cause serious food poisoning in their host and are occasionally responsible for product recalls due to food contamination (Vogt and Dipploid, 2005).

The harmless strains are part of the normal flora of the gut and can benefit there by producing vitamin K2 and preventing colonization of the intestine with pathogenic bacteria. Escherichia coli is expelled into the environment within fecal matter. The bacterium grows massively in fresh fecal matter under aerobic condition for three days but it’s number decline slowly afterwards (Russel and Jarvis, 2001). Strains of Escherichia coli that causes disease outside of the gastro-intestinal tracts are referred to as extra-intestinal pathogenic Escherichia coli (EXPEC) and are divided into uropathogenic Escherichia coli (UPEC) strains causing neonatal meningitis and septicemic Escherichia coli. Uropathogenic Escherichia coli is the most common pathotype of EXPEC and is found in patient with urinary tract infections (Katouli, 2010).

The infection of urinary trait by Escherichia coli are important and serious problems in the clinical field. It is a leading pathogen causing urinary trait infection (UTI) and is among the most common pathogen causing blood stream infections, wound, otitis media and other complications in human. It also the common causes of food and water-bone human diarrhea worldwide and in developing countries causing many deaths in children under the age of five (Kashef et al ., 2010).
Urinary tract infection (UTI) is one of the most important causes of morbidity and health care expenditure in persons of all ages and is the second most common causes of hospital visit.
Escherichia coli is one of the most common causes of community – acquired and nosocomial infections.
This organism is therefore of clinical importance and can be isolated from various clinical specimens.
Escherichia coli have been documented as the most important pathogen associated with Urinary tract infections in many countries. Urinary tract infections including cystitis and pyelonephritis, are the most common infectious disease in child hood.
Escherichia coli accounts for as much as 90% of the community-acquired and 50% of the nosocomial infections.
Urinary tract infections are more commonly among women than men, although the prevalence in elderly men and women is similar. Most of the research on Urinary tract infection has focused on young sexual active women who are at high risk for developing an infection (Kolowale et al., 2009).

ANTIBIOGRAM OF ESCHERICHIA COLI IN URINE SAMPLES OF OUT-PATIENT FROM ST. MARY’S HOSPITAL URUA AKPAN