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

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 (χ 2 =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.

Prevalence of Extended-Spectrum β-Lactamase-Production among Clinical Gram-Negative Bacilli Isolates in A Tertiary Hospital, Southwest Nigeria

“…The high frequency of E. coli isolation indicates its continued significance in the aetiology of urinary tract infections, gastrointestinal infections and bloodstream infections, which accounted for more than 85% of suspected clinical infections in this study. Majority of the Gram-negative isolates were from urine samples, which formed the highest number of clinical samples in this study, supporting the fact that urine is the most common routine samples received at the clinical microbiology laboratory, even as E. coli is the most common bacteria aetiology of uncomplicated urinary tract infection [17]. Antimicrobial resistance in the health care setting, although not a new problem, is worrisome as it affects the efficacy of antimicrobial agents.…”

Detection of tem-1 and class-1 integrons in multidrug resistant uropathogens from HIV patients with asymptomatic bacteriuria in a Tertiary Care Hospital, SouthWest Nigeria

“…Isolation of S. aureus and S epidermidis is not limited to our study. Previous studies in the study environment and across the globe similarly reported them as frequently isolated uropathogens 14,30,34 . Isolation of these bacteria may be because they are mostly normal skin flora and can be accidentally introduced to the urethra during sexual intercourse 37 .…”

“…Globally, E. coli is the commonest uropathogens implicated in ASB 32 , 33 . Previous studies in Nigeria have also reported it as the commonest pathogen implicated in ASB 28 , 34 . Consequently, its dominance is in tandem with the previous reports.…”