摘要
<strong>Background: </strong>Urinary tract infections (UTIs) in women with bacterial vaginosis (BV) continue to pose tremendous health concerns and require appropriate use of antibiotics for effective case management. This study determined the prevalence, etiology and antibiotic resistance profile of uropathogenic bacteria isolated from sexually active women with BV in Lagos Nigeria. <strong>Method:</strong> A total of 258 sexually active women presenting with gynaecological complaints at the maternal and child unit of twenty Primary Health Care Centres in Lagos Nigeria from May 2017 to March 2018 were consecutively enrolled with consent. Bacterial vaginosis was diagnosed based on Amsel criteria. Midstream urine samples were collected aseptically, analyzed for bacterial pathogens and antibiotic susceptibility using standard microbiological methods. <strong>Results:</strong> BV was diagnosed in 184 (71.3%) with 69.2% also having UTI. Ninety four (36.4%) had UTI predominantly caused by Gram negative bacteria (96.8%). The organisms isolated were <em>Escherichia coli</em> 79 (84.0%), <em>Klebsiella pneumoniae</em> 5 (5.3%), <em>Pseudomonas aeruginosa</em> 4 (4.3%), <em>Proteus mirabilis</em> 3 (3.2%) and <em>Staphylococcus saprophyticus</em> 3 (3.2%). The pathogens elicited high resistance (66.7% - 100%) to tetracycline, amoxicillin-clavulanic acid, nitrofurantoin and cephalosporins, and moderate resistance (50%) to ofloxacin by <em>P. aeruginosa</em> strains. The isolates were susceptible (100%) to piperacillin-tazobactam and meropenem. Multi-drug resistance (MDR) was observed among 97.8% of the bacteria isolated. <strong>Conclusion: </strong>Findings from this study indicate high occurrence of UTI caused by MDR pathogens among sexually active women with BV with emerging evidence of poor clinical utility of nitrofurantoin and other commonly used first-line antibiotics against UTI. Further studies on non-bacterial aetiology of BV, molecular characterization of <em>S. saprophyticus</em> and Gram Negative Bacteria UTI
<strong>Background: </strong>Urinary tract infections (UTIs) in women with bacterial vaginosis (BV) continue to pose tremendous health concerns and require appropriate use of antibiotics for effective case management. This study determined the prevalence, etiology and antibiotic resistance profile of uropathogenic bacteria isolated from sexually active women with BV in Lagos Nigeria. <strong>Method:</strong> A total of 258 sexually active women presenting with gynaecological complaints at the maternal and child unit of twenty Primary Health Care Centres in Lagos Nigeria from May 2017 to March 2018 were consecutively enrolled with consent. Bacterial vaginosis was diagnosed based on Amsel criteria. Midstream urine samples were collected aseptically, analyzed for bacterial pathogens and antibiotic susceptibility using standard microbiological methods. <strong>Results:</strong> BV was diagnosed in 184 (71.3%) with 69.2% also having UTI. Ninety four (36.4%) had UTI predominantly caused by Gram negative bacteria (96.8%). The organisms isolated were <em>Escherichia coli</em> 79 (84.0%), <em>Klebsiella pneumoniae</em> 5 (5.3%), <em>Pseudomonas aeruginosa</em> 4 (4.3%), <em>Proteus mirabilis</em> 3 (3.2%) and <em>Staphylococcus saprophyticus</em> 3 (3.2%). The pathogens elicited high resistance (66.7% - 100%) to tetracycline, amoxicillin-clavulanic acid, nitrofurantoin and cephalosporins, and moderate resistance (50%) to ofloxacin by <em>P. aeruginosa</em> strains. The isolates were susceptible (100%) to piperacillin-tazobactam and meropenem. Multi-drug resistance (MDR) was observed among 97.8% of the bacteria isolated. <strong>Conclusion: </strong>Findings from this study indicate high occurrence of UTI caused by MDR pathogens among sexually active women with BV with emerging evidence of poor clinical utility of nitrofurantoin and other commonly used first-line antibiotics against UTI. Further studies on non-bacterial aetiology of BV, molecular characterization of <em>S. saprophyticus</em> and Gram Negative Bacteria UTI
作者
Chinedum Taahie Oparaugo
Bamidele Abiodun Iwalokun
Adesegun Abiola Adesesan
Idowu Olaide Edu-Muyideen
Abimbola Modupe Adedeji
Oliver Chukwujekwu Ezechi
Mopelola Anotu Deji-Agboola
Chinedum Taahie Oparaugo;Bamidele Abiodun Iwalokun;Adesegun Abiola Adesesan;Idowu Olaide Edu-Muyideen;Abimbola Modupe Adedeji;Oliver Chukwujekwu Ezechi;Mopelola Anotu Deji-Agboola(Biochemistry & Nutrition Department, Nigerian Institute of Medical Research, Lagos, Nigeria;Department of Medical Microbiology & Parasitology, Olabisi Onabanjo University, Ago-Iwoye, Nigeria;Molecular Biology & Biotechnology Department, Nigerian Institute of Medical Research, Lagos, Nigeria;Central Research Laboratory, Nigerian Institute of Medical Research, Lagos, Nigeria;Microbiology Department, Nigerian Institute of Medical Research, Lagos, Nigeria;Monitoring & Evaluation Unit, Nigerian Institute of Medical Research, Lagos, Nigeria;Clinical Science Department, Nigerian Institute of Medical Research, Lagos, Nigeria)
