Bacterial Urinary Tract Infections among Males with Lower Urinary Tract Obstruction at Komfo Anokye Teaching Hos-pital, Kumasi, Ghana

Abstract

Purpose: We describe the commonest pathology responsible for lower urinary tract obstruction (LUTO) and associated symptoms such as UTI, etc. among males at the Komfo Anokye Teaching Hospital (KATH) in Kumasi. Materials and Methods: Between January and December 2009, prospective cross sectional hospital based study was conducted involving 103 subjects. Patients with symptoms of LUTO and who were on short admission (up to 48 hours) at the accident and emergency unit of KATH were identified as potential study subjects. All the patients presented with acute retention of urine at the emergency unit of KATH and urethral catheterization was attempted to relieve them of the retention under sterile conditions. Those patients whose initial catheterization failed went through suprapubic cystostomy (suprapubic catheterization). Urine specimens for culture and sensitivity tests were then collected into sterile urine containers immediately after the catheterization (irrespective of type). Ultrasound Scan was requested for all the patients to assist in diagnosing enlargement of the prostate and other associated urological pathologies. Retrograde urethrogram was however, requested for those patients with suprapubic catheterization and which helped in the diagnosis of the urethral stricture. For a particular child, urethral catheter was passed under sterile condition and Micturicting Cysto-Urethrogram (MCUG) was done to assist in diagnosing posterior urethral valve and other conditions. Those subjects whose urinalysis revealed pyuria and positive urine culture and who had voluntarily agreed to enter the study were enrolled. Subjects whose urine culture had multiple bacteria growth that was deemed to be contaminants were excluded from the study. Results: The mean age for males with LUTO was 62 years. The youngest male with LUTO was aged 2 years whilst the maximum age was 93 years. LUTO due to prostatic hyperplasia was found in 79 (76.7%) men; 23 (22.3%) had LUTO due to urethral stricture and 1 (1.0%) (youngest male). The mean age of patients that had LUTO due to urethral stricture was approximately 39 years. The youngest patient with LUTO due to urethral stricture aged 22 years whilst the maximum age was 72 years. Microbiological results indicated that <i>Escherichia coli</i> caused 53 (51.5%) of urinary tract infection (UTI) due to LUTO; <i>Klebsiella</i> = 23 (22.3%); <i>Staphylococcus aureus</i> = 14 (14.6%); <i>Pseudomonas</i> spp. = 8 (7.8%) <i>Proteus</i> = 2 (2.0%); <i>Citrobacter</i> = 1 (1.0%) and <i>Salmonella</i> spp. =1 (1.0%). Conclusion: The most common cause of lower urinary tract obstruction (LUTO) in Kumasi, Ghana is prostatic hyperplasia and the commonest causative organism of the associated UTI symptom is <i>Escherichia coli</i>

Urinary Retention in Adults Male Patients: Causes and Complications among Patients Managed in a Teaching Hospital in North Western Nigeria

“…Similarly, all the organisms responsible for UTI in this study were gram negative bacteria, which are the commonest pathogens of the urinary tract [10] [20]. The findings were similar to the one found by Abaeze S, et al in a study on "The prevalence of urinary catheter related infections in Federal Medical Centre, Abeokuta, Nigeria" [21] and Christian Kofi Gyasi-Sarpong, et al at Kumasi, Ghana [22]. In both studies, E. coli was the commonest pathogen isolated, followed by Klebsiella specie.…”

Urinary Tract Infections among Bladder Outlet Obstruction Patients in Accra, Ghana: Aetiology, Antibiotic Resistance, and Risk Factors

“…The focus of this study was to provide data on antibiotic resistance of uropathogens associated with BOO patients with the goal of improving treatment outcomes of urinary tract infections in the patients. The mean age (69.1 years) of the participants in this study is similar to that of a previous study on urinary tract infection among BOO patients in Kumasi, Ghana in which the mean age reported was 62.0 years [ 8 , 16 ]. The most frequent cause of BOO in this study were benign prostatic hyperplasia (73.9%) and urethral stricture (13.3%), which concurs with the previous study in Kumasi, which reported 76.7% prostatic hyperplasia prevalence and 22.3% urethral stricture [ 8 , 16 ].…”

“…The mean age (69.1 years) of the participants in this study is similar to that of a previous study on urinary tract infection among BOO patients in Kumasi, Ghana in which the mean age reported was 62.0 years [ 8 , 16 ]. The most frequent cause of BOO in this study were benign prostatic hyperplasia (73.9%) and urethral stricture (13.3%), which concurs with the previous study in Kumasi, which reported 76.7% prostatic hyperplasia prevalence and 22.3% urethral stricture [ 8 , 16 ]. The prevalence of urinary tract infection among BOO patients in this study (76.6%) is much higher than that reported in Kumasi (40.2%) by Gyasi-Sarpong et al, 2014 [ 8 ].…”

Comparative in vitro activity of ciprofloxacin and levofloxacin against isolated uropathogens in Ghana: a pilot study

“…The current study also showed that Escherichia coli and Coliform spp were the most prevalent uropathogens, accounting for 71.3% of the clinical isolates. Similar studies in Ghana; Kumasi and Cape Coast Hospitals, however, reported Escherichia coli and Klebsiella spp as the most prevalent bacteria isolates responsible for UTI [ 30 , 31 ].…”