ABSTRACTS
Urinary tract infections (UTI) are systemic infections that pose great problem to the health care delivery system worldwide. More importantly, the uropathogenic isolates are becoming more resistant to commonly used antimicrobial agents. In order to evaluate the extent of significant bacteriuria in Abuja and environs, pre-study survey by way of questionnaire was carried out. The outcome showed a high prevalence of significant bacteriuria in Abuja and surrounding settlements. Furthermore the research work was designed to undertake the isolation, characterization and assessment of the susceptibility profile of the pathogenic isolates involved in urinary tract infections. The degree of resistance and prevalence of multiple antibiotic resistant (MAR) of the isolates was examined using multiple antibiotic resistance index. The minimum inhibitory concentrations (MIC) of ampicillin and streptomycin against the seventeen (17) multiple antibiotic resistant (MAR) isolates was determined using the macrobroth dilution method. The involvement of either plasmid or chromosome in the drug resistant of the isolates was investigated using acridine-curing experiment. The biochemical mechanism of bacterial resistance was investigated by screening for the production of β-lactamase enzymes. Out of a total of 305 suspected bacteriuria cases from five different healthcare Institutions in Abuja and environ, 96 (31.5%) of them were adjudged of having urinary tract infections. From the positive samples, 100 16 uropathogenic organisms were isolated. They comprised of E. coli (33%), Proteus spp (32%), Klebsiella spp (14%), Staph. aureus (11%), Streptococcus spp (6%) and Ps aeruginosa (4%). The increase in incidence of UTI pathogens in term of number of isolates was in the order of Asokoro > Gwagwalada > National Hospital (central area) > Maitama > Durumi. The susceptibility test showed that a high percentage of the isolates was sensitive to gentimicin, ceftriaxone, ciprofloxacin, ofloxacin, pefloxacin, lincomycin, co-trimoxazole, rifampicin, chloramphenicol, nitrofurantoin, norfloxacin, streptomycin, nalidixic acid, ampicillin/cloxacillin (ampicloxR ) and cephalexin, while lower percentage of the isolates was susceptible to ampicillin and tetracycline. The incidence of resistance to several antibiotics as judged by the multiple antibiotic resistance index (MARI) was in the order of Pseudomonas aeruginosa >Streptococcus spp >Staphylococcus aureus >Klebsiella spp >Proteus spp >Escherichia coli. The MICs of ampicillin and streptomycin to some of the resistant isolates were of the values between 73-1250 μg/ml and 156-2500 μg/ml respectively. From acridine orange curing experiment 71% and 83% of the resistant isolates showed the reduction in MIC values of ampicillin and streptomycin respectively suggesting that plasmids and in some cases chromosome were responsible for the resistance to ampicillin and streptomycin. Majority, (56%) of multiple antibiotic resistance (MAR) isolates were positive to β-lactamase enzyme production indicating that enzymatic detoxification is one of the major mechanisms of antibiotic resistance.
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CHAPTER ONE:
INTRODUCTION
Background...