Bacterial Profile And Antimicrobial Susceptibility Patterns In Patients With Indwelling Urinary Catheters In Federal Medical Centre, Umuahia. Abia State:- Iwu, Justus O

ABSTRACT

The microbial pathogens associated with bacteriuria and Urinary tract infection in patients with indwelling urethral catheters and their susceptibility patterns to commonly used antimicrobial agents were determined. Catheter urine and catheter tip specimens of all the patients were analyzed by microscopy and culture on Blood agar, MacConkey and CLED agar plates. Microbial isolates were characterized biochemically and disc diffusion antibiotic susceptibility was also performed. The common indication for catheterizations are. Bladder out let obstruction (28%), urinary incontinence (20%), diabetes mellitus (6%), acute abdomen (6%), CVA (8%), femoral fracture(6%). Urine culture positive for microbial pathogens with 40(80%) microbial isolates, Pseudomonas aeruginosa were the commonest pathogen isolated with 16(32%), followed by Escherichia coli 9(18%), Staphylococcus aureus 3(6%), Proteus mirabilis 7(14%), Klebsilla pneumonae 5(10%). The in vitro antibiotic susceptibility pattern ofthe Gram negative organisms showed high resistance to commonly used antibiotics such as ampicillin (100%), gentamicin (92.5%), tetracycline (100%), cotrimoxazole (72.5%), nalidixic acid (100%), nitrofurantoin (82.5%), colistin (0.0%), penicillin (100%), chloramphenicol (100%), cioxacillin (95%), streptomycin (82.5%). Staphylococcus aureus isolates were also resistant to penicillin (100%), gentamicin(100%), cotrimoxazole(100%), chloramphenicol (100%), cioxacillin (36%), tetracycline (100%), nalizidic acid (100%), streptomycin (34%), nitrofurantoin (100%), ampicillin (100%). Only Colistin (100%) appear effective. In both male and female gender, the rate of infection was higher in female patients, older patients (>40 years) were found to be the most affected age group (74%). In addition, increasing resistance in pathogens isolated from catheterized patients is frustrating because the most important risk factor for Urinary tract infection is duration of catheterization. Therefore, indwelling urinary catheterization should be avoided ifpossible or at least minimized.