Antimicrobial susceptibility patterns of uropathogenic microorganisms associated with vesico-vaginal fistula (VVF) patients in Abakaliki, South eastern Nigeria

Abstract

The objective of this study was to review the antimicrobial susceptibility patterns of uropathogenic microorganisms associated with VVF patients in Abakaliki, South eastern Nigeria. Out of the 117 bacterial isolates obtained from 108 mid-stream urine samples of VVF patients, 72 isolates [15 (20.8%) Staphylococcus aureus, 8 (11.1%) Enterococcus faecalis, 12 (16.7%) Klebsiella pneumoniae, 11 (15.3%) Proteus mirabilis, and 26 (36.1%) Escherichia coli] were obtained from pre-surgery VVF patients, while 45 isolates [7 (15.6%) Staphylococcus aureus, 3 (6.7%) Enterococcus faecalis, 4 (8.9%) Klebsiella pneumoniae, 15 (33.3%) Proteus mirabilis, and 16 (35.6%) Escherichia coli] were obtained from postsurgery VVF patients. The bacterial isolates exhibited resistance (57.1 to 75%) to co-trimoxazole, tetracycline, amoxicillin, ceftazidime, and nitrofurantoin. Antibiogram also revealed that imipenem was the most active antibiotic against the bacterial isolates as 80 to 100% of the bacterial isolates were susceptible to this antibiotic. Our findings affirmed that VVF patients are prone to microbial colonization and these microbes showed varying degrees of susceptibility to different classes of antibiotics. Therefore, there is urgent need for constant monitoring and evaluation of antibiotics used in the treatment of uropathogenic infections in VVF patients to avoid full-blown antibiotic resistance menace which might eventually result in serious public health problem.

Microbial Culture Characteristics and Antimicrobial Susceptibility Patterns Associated with Vesicovaginal Fistula

“…The highest resistance pattern, reaching more than 70%, was found in the antibiotics tetracycline, amoxicillin, and cotrimoxazole, while the sensitivity pattern reached up to 100% in imipenem antibiotics. 3 Thus, in our study, antibiotics that could be considered for urinary tract infections caused by gram-negative bacterial infections in vesicovaginal fistula patients were aztreonam, ertapenem, and meropenem, with susceptibility…”

“…16 In contrast, four previous studies, including research by Ugbo et al showed a high sensitivity pattern found in the antibiotics gentamicin, ciprofloxacin, nitrofurantoin, ofloxacin, and imipenem. 3 Research by Dereje et al (2017), a pattern of high sensitivity was found for the antibiotics amoxicillin and ciprofloxacin. 14 Research by Marami et al (2022), a pattern of high sensitivity was found for the antibiotics penicillin and cefoxitin.…”

“…2 Other causes of VVF are radiation therapy for malignant disease or accidental surgical injury to the bladder during procedures such as hysterectomy, malignant neoplasms, and pelvic irradiation. 3 VVF can often be found in developed countries with a yearly incidence of 50,000-100,000 cases and more than 2 million women being affected worldwide. VVF is a weakening condition that could cause a persistent badsmelling odor combined with urinary discharge that would, later on, lead to the excoriation of the vulva and vagina.…”