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Biochemical and bacteriological profiles of asymptomatic bacteriuria among school children in Ago-Iwoye, Nigeria

Popoola, O. D., Agu, G. C., Oyeyipo, F. M., and *Thomas, B. T.
Department of Microbiology, Olabisi Onabanjo University, Ago Iwoye, Ogun State, Nigeria
*Correspondence to: benthoa2013@gmail.com; ORCID: //orcid.org/0000-0003-0675-5749

Abstract:
Background: Asymptomatic bacteriuria (ASB) in children is a predisposing factor to symptomatic urinary tract
infection (UTI) that may be complicated by blood stream infections if not appropriately treated with resultant
mortality or morbidity. The objectives of this study are to determine the prevalence of ASB, and evaluate both
biochemical and bacteriological characteristics of urine samples of primary school pupils in Ago-Iwoye, Ijebu North
Local Government Area (LGA), Ogun State, Nigeria.
Methodology: Three hundred and seventy-two (186 males and 186 females) apparently healthy (asymptomatic)
pupils aged 2-16 years from four randomly selected primary schools in the LGA were screened for ASB. Clean catch
specimen of midstream urine was collected from each subject. Biochemical analysis of the urine was performed
with Combi 10 reagent strip. MacConkey and Cysteine Lactose Electrolyte Deficient (CLED) agar plates were
inoculated with calibrated wireloop delivering 0.01 ml of urine for aerobic culture at 37oC for 24 hours.
Identification of significant bacteria on culture plates was done using conventional biochemical tests.
Results: The frequency of clear, slightly turbid and turbid urine were 31 (8.3%), 99 (26.6%) and 56 (15.1%)
respectively. All analyzed urine samples were alkaline and negative for ketone, glucose and blood, but contained
protein in 230 (61.8%), bilirubin in 184 (49.5%), nitrites in 64 (17.2%) and urobilinogen in 14 (3.7%) subjects.
The prevalence of significant bacteriuria was 11.8% (44 of 372) with 7.0% in males and 16.7% in females (p =
0.0063). The frequency of bacteria isolated in descending order were Escherichia coli 61.4%, Staphylococcus
saprophyticus 61.4%, Staphylococcus aureus 45.5%, Bacillus subtilis 45.5%, Enterococcus faecalis 43.2%,
Enterobacter spp 36.4%, Serratia marscencen 31.8%, Klebsiella pneumoniae 22.7%, Proteus mirabilis 22.7% and
Pseudomonas aeruginosa 20.5%.
Conclusion: This result highlights the presence of significant bacteriuria among apparently healthy pupils in the
study area, with higher prevalence in the female pupils. The apparent risk of developing symptomatic UTI with the
attendant complications in these pupils should spur preventive education of parents/guardians and the general
populace about this entity.

Keywords: Asymptomatic bacteriuria, S. saprophyticus, morbidity, prevalence, primary school pupils

Received April 11, 2019; Revised June 09, 2019; Accepted June 12, 2019
Copyright 2019 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0
International License (//creativecommmons.org/licenses/by/4.0), which permits unrestricted use, distribution and reproduction
in any medium, provided credit is given to the original author(s) and the source.

Profils biochimiques et bactériologiques de la bactériurie
asymptomatique chez des écoliers à Ago-Iwoye, Nigéria

Popoola, O. D., Agu, G. C., Oyeyipo, F. M., et *Thomas, B. T.
Département de microbiologie, Université Olabisi Onabanjo, Ago-Iwoye, État d’Ogun, Nigéria
*Correspondance à: benthoa2013@gmail.com; ORCID: //orcid.org/0000-0003-0675-5749

Abstrait:
Contexte: La bactériurie asymptomatique chez l’enfant est un facteur prédisposant à l’infection symptomatique
des voies urinaires qui peut se compliquer d’infections du flux sanguin s’il n’est pas traité correctement avec la
Asymptomatic bacteriuria in school children Afr. J. Clin. Exper. Microbiol. 2019; 20 (4): 299-305
300
mortalité ou la morbidité qui en résulte. Les objectifs de cette étude sont de déterminer la prévalence d’ASB et
d’évaluer les caractéristiques biochimiques et bactériologiques d’échantillons d’urine d’élèves du primaire à Ago-
Iwoye, région du gouvernement local d’Ijebu North, État d’Ogun, au Nigéria.
Méthodologie: Trois cent soixante douze (186 garçons et 186 filles) des élèves apparemment sains
(asymptomatiques) âgés de 2 à 16 ans de quatre écoles primaires sélectionnées au hasard dans la LGA ont été
soumis à un dépistage du PNA. Des échantillons de capture d’urine à mi-parcours ont été recueillis chez chaque
sujet. L’analyse biochimique de l’urine a été réalisée avec une bandelette de réactif Combi 10. Des plaques de
gélose MacConkey et Cysteine Lactose Déficient en électrolyte (CLED) ont été inoculées avec du fil électrolytique
calibré, délivrant 0,01 ml d’urine pour une culture aérobie à 37 ° C pendant 24 heures. L’identification des
bactéries significatives sur des plaques de culture a été réalisée à l’aide de tests biochimiques classiques
Résultats: La fréquence des urines claires, légèrement troubles et troubles était respectivement de 31 (8,3%), 99
(26,6%) et 56 (15,1%). Tous les échantillons d’urine analysés étaient alcalins et négatifs pour la cétone, le glucose
et le sang, mais contenaient des protéines chez 230 (61,8%), de la bilirubine chez 184 (49,5%), des nitrites chez
64 (17,2%) et de l’urobilinogène chez 14 (3,7%). La prévalence de la bactériurie significative était de 11,8% (44
sur 372) avec 7,0% chez les hommes et 16,7% chez les femmes (p = 0,0063). La fréquence des bactéries isolées
par ordre décroissant était Escherichia coli 61,4%, Staphylococcus saprophyticus 61,4%, Staphylococcus aureus
45,5%, Bacillus subtilis 45,5%, Enterococcus faecalis 43,2%, Enterobacter spp 36,4%, Serratia marcescens
31,8%, Klebsiella pneumoniae, Proteus mirabilis 22,7% et Pseudomonas aeruginosa 20,5%.
Conclusion: Ce résultat met en évidence la présence d’une bactériurie significative chez les élèves apparemment
en bonne santé dans la zone d’étude, avec une prévalence plus élevée chez les élèves de sexe féminin. Le risque
apparent de développer une infection urinaire symptomatique accompagnée des complications associées chez ces
élèves devrait inciter à l’éducation préventive des parents / tuteurs et de la population en général sur cette entité.

Mots-clés: bactériurie asymptomatique, S. saprophyticus, morbidité, prévalence, élèves du primaire

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Biochemical and bacteriological profiles of asymptomatic bacteriuria among school children in Ago-Iwoye, Nigeria

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Asymptomatic bacteriuria in an apparently healthy population and its relation to hypertension

B.W. Odetoyin, O Olaniran, D.O. Afolayan, I.A. Aderibigbe, O Alaka, A.A. Onanuga

 

Abstract

Background: Hypertension is a major health problem in sub-Sahara Africa. Several studies have suggested a role of asymptomatic bacteriuria (ASB) in the aetiology of hypertension, but there is a dearth of information on this association in Africa where the burden of hypertension is high. We investigated the prevalence of asymptomatic bacteriuria, its association with hypertension and determined the antibiotic resistance patterns of implicated bacterial isolates in an urban community of Ile-Ife.

Methods: One hundred and seventy-four apparently healthy individuals were investigated for ASB. Relevant information was obtained from them with standard proforma. Their Blood pressure was measured with a standard mercury sphygmomanometer. All samples were processed on cysteine lactose electrolyte deficient medium and chocolate agar. Antimicrobial susceptibility testing was done using Kirby-Bauer disk diffusion technique.

Results:Fifty (28.7%) individuals were positive for ASB. ASB was commonly detected among the female subjects (X2=5.619; p-value = 0.01777), and among individuals in the age group of 50 59 years. Those that were hypertensive were two and a half times more likely to have ASB (Odd ratio=2.5; p-value=0.01369; CI=1.19-5.35). The highest percentage of hypertensive female participants with ASB was found in the age group of 30-39 years (33.3%) while among the male participants, the highest percentage was found in the age group of 60-69 years (9.5%). Escherichia coli (n=13; 26%) and Staphylococcus aureus (n=13; 26%) were the commonest organisms implicated in ASB. The majority of the isolates (>90%) were multidrug resistant. Isolates of Escherichia coli were commonly resistant to ampicillin (83.3%), ceftriaxone (72.7%) and cefepime (66.7%). Isolates of Staphylococcus aureus were all (100%) resistant to erythromycin, cloxacillin and streptomycin. All isolates were least resistant to cotrimoxazole (<8%).

Conclusion: Women as well as men in the age group of 50-59 years were more likely to develop ASB. ASB could be contributing to the rising incidence of hypertension in this environment. Co-occurrence of hypertension and ASB portends a grave problem for apparently healthy individuals in this environment.

Keywords: Asymptomatic bacteriuria, Hypertension, Escherichia coli, healthy individuals, urban community

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Asymptomatic bacteriuria in an apparently healthy population and its relation to hypertension

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Epidemiological Study Of Asymptomatic Bacteriuria Among Nursery School Children In Ahvaz, Iran

M Jalali, T Asteraki, E Emami-Moghadam, E Kalantar

 

Abstract

This study was undertaken to determine the prevalence of asymptomatic bateriuria in preschool children of different age and sex groups and to isolate the organisms responsible for asymptomatic bacteriuria and determine their antimicrobial susceptibility pattern. A total of 475 children from 17 nurseries in Ahvaz city, Iran were screened by collecting mid-stream urine samples for the presence of causative organisms. Asymptomatic bacteriuria was observed in 16 cases (3.36%). The isolated pathogens included Escherichia coli (50 %), Proteus mirabilis (25 %) and coagulase negative staphylococcus (25 %). The antibiograms indicated that Gentamicin (100 %), Nalidixic acid (100 %), Amikacin (75%), Kanamycin (75 %), Nitrofurantoin ( 62.5 %), Tobramycin ( 62.5 %), Tetracycline ( 50 %) and Chloramphenicol (37.5%), were in that order the most effective of the antibiotics tested against E. coli isolates. Proteus mirabilis showed 100% sensitivity to Amikacin, Gentamicin, Kanamycin, Nalidixic acid and Tobramycin followed by Nitrofurantoin (75%), Cephalotin (50%) and Chloramphenicol (50%). Similarly, antibiogram of coagulase negative staphylococcus showed 75% sensitivity to both Nalidixic acid and Kanamycin. This result indicated a significant rise in the frequency of Escherichia coli in asymptomatic bacteriuria.
Key words: Asymptomatic bacteriuria, children, urinary tract infections

Afr. J. Clin. Exper. Microbiol. 2005; 6(2): 159-161

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ASYMPTOMATIC SIGNIFICANT BACTERIURIA AMONG PREGNANT WOMEN IN ADO-EKITI, EKITI STATE, NIGERIA

AO Oyagade, SI Smith, O Famurewa

 

Abstract

Microbiological culture examination of urine samples from 502 pregnant women attending antenatal clinic resulted in the isolation of seven genera of bacterial species. They were Staphylococcus aureus 16 (21.3%), Escherichia coli 12 (16.0%), Staphylococcus spp. 11(14.7%), Klebsiella spp. 8 (10.7%), Pseudomonas aeruginosa 7 (9.8%), Streptococcus faecalis 6 (8.0%), and Citrobacter spp. 1 (1.3%). Asymptomatic significant bacteriuria occurred in 16 (12.22%), pyuria in 10 (2.0%) while significant bacteriuria with pyuria occurred in 1(0.2%). The antibiogram indicated that ofloxacin, ciprofloxacin and nalidixic acid were in that order the most effective of the antibiotics tested. All isolates showed multiple resistance to most of the antibiotics tested. Plasmid DNA was detected in Ps. aeruginosa and E. coli with an estimated molecular weight of between 4.5 and 6.5 kb. The result indicated a significant rise in the frequency of S. aureus in asymptomatic bacteriuria.

Key Words: Asymptomatic bacteriuria, urinary tract infections, pregnant women

African Journal Of Clinical And Experimental Microbiology Jan 2004 Vol.5 No.1 64-77

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METHICILLIN RESISTANCE IN STAPHYLOCOCCAL ISOLATES FROM CLINICAL AND ASYMPTOMATIC BACTERIURIA SPECIMENS: IMPLICATIONS FOR INFECTION CONTROL

B.O. Olayinka, A.T. Olayinka

 

Abstract

The study assessed the importance of Staphylococcus aureus as a urinary pathogen and the incidence of multidrug resistant (MDR), methicillin-resistant Staphylococcus aureus (MRSA). A total of 86 staphylococcal isolates made up of 50 clinical isolates from urine samples submitted to the Medical Microbiology Laboratory of Ahmadu Bello University Teaching Hospital and 36 asymptomatic bacteriuria isolates from urine samples of ‘healthy’ volunteers within the university community were tested for their susceptibility to various antibiotics and production of b-lactamase enzyme. A total of 27 isolates (31.4%) were methicillin resistant, with 12(44.4%) being methicillin resistant coagulase-negative staphylococci (MRCNS). Majority of the isolates tested were resistant to the cheap, readily available broad-spectrum antibiotics; ampicillin, amoxicillin, chloramphenicol, tetracycline and penicillin G. All the isolates were resistant to three or more of the antimicrobial agents tested. A total of 14/50 (28%) of the clinical isolates and 17/36 (47.2%) of the ‘community’ isolates from healthy volunteers were resistant to 7 or more of the antimicrobial agents tested. Analysis of the multiple antibiotic resistance (MAR) index of isolates and the production of b-lactamase enzyme showed that 56 isolates representing 65.1% of the total number tested had an MAR index of 0.5 and above indicating that they probably originated from an environment where antibiotics are frequently used. The implication of these findings for instituting effective control measures aimed at reducing the pool of antibiotic-resistant organisms is discussed.

Key words: Methicillin-resistant, staphylococcus aureus, asymptomatic bacteriuria, infection control
(Af J Clinical & Exp Microbiology: 2003 4(2): 79-90)