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

ABSTRACT

In order to access the prevalence and sensitivity pattern of urinary pathogens, 60 midstream urine samples from students of Caritas University were investigated using cultural methods. Samples were examined microscopically and cultured in blood agar and Macckonkey agar. Disk diffusion method was used for antibiotic testing. Of the 60 urine samples 48 yielded significant growth with a prevalence rate of 80%. It was observed that females were more infected than the males with a prevalence rate of 56.70% and 43.30% respectively under the ages of 18-25yrs. Escherichia coli was the most predominant. The isolates were very sensitive to Gentamycin, Nitrofurantoin and Ofloxacin which were the (most sensitive) and the most resistant were Tetracycline, Cortrimozol, Cephalexin and Ampicillin. Therefore, Nitrofurantoin, Gentamycin, Ofloxacin were strongly recommended for the treatment of UTI as indicated in the study.

TABLE OF CONTENT

Title page
Certification
Dedication
Acknowledgement
Abstract
Tables of contents
List of tables

CHAPTER ONE
1.0 INTRODUCTION 
1.1 Aims and objectives of the study

CHAPTER TWO
2.0 LITERATURE REVIEW 
2.1 Microorganisms found in urine and their etiology
2.1.1 Bacteria
2.1.2 Viruses
2.1.3 Fungi
2.1.4 Protozoa
2.2.1 Entry of bacteria into the urinary tract
2.2.2 Routes of bacteria infection
2.2.3 Symptoms of UTI
2.2.4 Diagnosis
2.2.5 Treatment
2.2.5.1 Aims of treatment of UTI
2.2.5.2 Future strategies in treatment of bacteria/UTI
2.2.6 Prevention and control
2.3.0 Antimicrobial resistance
2.3.1 Mechanisms of drug resistance
2.3.1.1 Drug- inactivating enzyme
2.3.1.2 Alteration in the target molecule
2.3.1.3 Decrease uptake of the drugs
2.3.1.4 Increased elimination of the drugs
2.3.2 Conditions influencing the effectiveness of drugs
2.3.2.1 Population size
2.3.2.2 Population composition
2.3.2.3 Concentration and intensity of antimicrobial agent
2.3.2.4 Duration of exposure
2.3.2.5 Temperature
2.3.3 Actions of antimicrobial drugs
2.3.3.1 Inhibition of cell synthesis
2.3.3.2 Inhibition of cell membrane
2.3.3.3 Inhibition of nucleic acid synthesis
2.3.3.4 Inhibition of essential metabolites

CHAPTER THREE
3.0 MATERIALS AND METHODS 
3.1 Sample collection
3.1.2 Antimicrobial susceptibility test
3.1.3 Urinalysis test
3.2 Gram staining
3.3 Biochemical test
3.3.1 Catalase test
3.3.2 Coagulase test
3.3.3 Motility test
3.3.4 Methyl test
3.3.5 Urease test
3.3.6 Indole test
3.3.7 Citrate utilization test

CHAPTER FOUR
4.0 RESULT

CHAPTER FIVE
5.1 DISCUSSION
5.2 Conclusion
5.3 Recommendation
References
Appendix I
Appendix II

CHAPTER ONE

INTRODUCTION
Gram negative bacteria are bacteria that do not retain their crystal violet dye in the gram staining protocol. They are differentiated by their cell wall structure. The following characteristics are displayed by gram negative bacteria as follows Cytoplasmic membrane Thin peptidoglycan layer(much thinner than gram positive) Outer membrane containing lipopolysaccharide outside the peptidoglycan layer Porin exists in the outer membrane, which acts like pores There is a space between the layer of peptidoglycan and the secondary cell membrane, called the periplasmic space If present, flagella have four (4) supporting rings instead of two No techoic acid or lipopolysaccharide
Some examples of gram negative bacteria include; Escherichia coli, Salmonella species, Pseudomonas species, Klebsiella species, Proteus species, Helicobacter species, Mosoxella species, Cyanobacteria species, Spirochetes species.
They also constitute a serious problem in urinary tract infections in many parts of the world. Appropriate antimicrobial treatments are often critical to decreasing morbidity and mortality among hospitalized patients having the infections caused by the pathogens. Gram negative bacteria are non-spore forming bacilli that grow rapidly on ordinary laboratory media under both aerobic and anaerobic conditions. It has been estimated that symptomatic urinary tract infects (UTI) occurs in as many as 7million visits to emergency units and 100,000 hospitalised annually. UTI has been the most common hospital acquired infections, accounting for as many as 35% of nosocomial infection. It is the second most common cause of bacteraemia in hospitalised patients (Nacem, 2000). UTI is known to occur in all populations but has a particular impact on females of all ages and males at two extremes of life, immuno-compromised patients and anyone with function or structural abnormalities of the urinary and excretory system.