Distribution and Antibiotic Susceptibility Pattern of Bacterial Pathogens Causing Urinary Tract Infection in Mubi General Hospital, Yola-Nigeria

Aims: This study was conducted to determine the distribution and antimicrobial susceptibility of uropathogens among patients attending Mubi general hospital as well as to determine the effect of gender on the etiology of bacterial uropathogens.
Study Design: Distributions of urinary isolates and their antibiogram
Place and Duration of Study: Mubi General Hospital, Adamawa State, between April, 2013 and January, 2014
Methodology: Urine samples of 101 patients comprised of 46 males and 55 females were analyzed for bacterial growth, antibiogram and multiple antibiotic resistance index.
Results: Females showed higher prevalence of UTI than males. Gram negative bacteria (61.7%) were found in high prevalence than Gram positive (29.3%). Staphylococcus aureus (58.3%) has the highest prevalence rate among Gram positive organisms, while Citrobacter freundii (25.3%) was the most prevalent Gram negative isolates. Citrobacter freundii (17.9%) was the most prevalent uropathogens closely followed by S. aureus (17.1%). Antimicrobial susceptibility was performed on all isolated bacteria by the disc diffusion method employing multiple antibiotic discs differently for both Gram positive and Gram negative isolates. The results showed that S. aureus and Coagulase Negative Staphylococci (CoNS) were more susceptible to Chloramphenicol (83%), followed by Streptomycin and Amoxicillin (78%). While their resistance profile showed that S. aureus and CoNS are more resistant to Ampiclox, Gentamycin and Rifampicin (31%). Susceptibility to all the antibiotics by Gram positive organisms was significantly higher than their resistance to the same antibiotics (p< 0.05). Gram negative organisms are more susceptible to Streptomycin (62%), followed by Ciprofloxacin (47%) and Ofloxacin (44%), while their resistance profile showed that they are more resistance to Nalixidic acid (79%) followed by Augmentin (76%), Ampicillin (75%) and Reflacine (74%). Resistance to all the antibiotics by Gram negative organisms is significantly higher than their susceptibility to the same antibiotics (p<0.05). Using spearman correlation, the results further showed significant correlation in resistance between P. vulgaris, Escherichia coli and P. agglomerans (p<0.01). Also, there was significant correlation in resistance between E. coli, Klebsiella sp., Citrobacter diversus and P. vulgaris (p<0.05). The multiple antibiotic resistances (MAR) index of each antibiotic was calculated. The MAR index for Gram positive antibiotics was significantly lower than that of Gram negative antibiotics (p<0.05).
Conclusion: In this study, we found multidrug resistance strains which are resistant to most of the antimicrobials agent tested more especially the Gram negative uropathogens. This reflected the fact that Nalixidic acid, Augmentin, Ampicillin, Reflacine, Ceporex and Septrin were the most commonly prescribed antibiotics in the hospital even before the results of urine analyses and also the most easily available in the market without prescription and because they were also very cheap in terms of cost. Consequently, the widespread use or misuse of antimicrobial drugs has led to a general rise in the emergence of resistant bacteria.