Evaluation of urinalysis parameters and antimicrobial susceptibility of uropathogens among out-patients at University of Cape Coast hospital

Abstract

Summary Background Urinary tract infection (UTI) is a major global public health issue. The gold standard for diagnosing UTI is urine culture. This is however labour intensive and time consuming. Many prescribers therefore rely on urinalysis in diagnosing UTI. This study sought to evaluate the performance of some parameters of urinalysis as predictors of urine culture positivity. The common causative agents and their antibiotic susceptibility patterns were also determined. Methods A cross sectional study was carried out at the University of Cape Coast Hospital from July 2017 – December 2017 among out-patients. The performance characteristics of leukocyte esterase (3+) and nitrite reactions were estimated and compared with urine culture. Antimicrobial susceptibility tests were done using disc diffusion technique described by Kirby-Bauer. Results Prevalence of UTI in this study was 30.0% (64/213). The most prevalent pathogen was E. coli (20, 31.2%), followed by S. saprophyticus (9, 14.1%). Most of the bacteria (52, 94.5%) were sensitive to amikacin, followed by ciprofloxacin (42, 76.3%). The most sensitive (94.4%) of the parameters was pus cells [>5 white blood cells (WBC) per high power field (HPF)] and the least sensitive was the nitrite test (21.0%). The leukocyte esterase test showed the highest accuracy of 91.1%. Conclusion The study supports the recommendation of the use of oral ciprofloxacin as the first line treatment of uncomplicated UTI by the Ghana Standard Treatment Guidelines (2017). Funding No funding was provided for this study.

The Effectiveness of Dipstick for the Detection of Urinary Tract Infection

“…As established, the presence of Enterobacteriaceae in the urinary tract invariably converts nitrate into nitrite. However, despite the fact that almost all isolates 64/65 (98.4%) recovered in this study belong to the family Enterobacteriaceae , performance of nitrite alone showed relatively low sensitivity 27.7 (95% CI = 17.3–40.2), similar to previous studies [15, 16] but approximately equal to that reported by Marques et al [17] (sensitivity = 28. 0%).…”

“…0%). Likewise, the study by Prah et al [15] and Marques et al [17] was conducted among a generalized cohort population irrespective of age, gender, and symptoms using the same quantitative urine culture cut-off (10 5 cfu/mL) as adopted by this present study. The low sensitivity value for nitrite could be explained by the fact that not all the isolates efficiently converted nitrate to nitrite or the patients may have passed out urine earlier before the sample collection, resulting in low nitrites concentration below detectable levels (although, participants were primed not to urinate before sample collection).…”

Drug-resistant, biofilm-producing uropathogens isolated and characterized from urinary tract infected patients in Chattogram, Bangladesh

“…Due to the abuse of antibiotics, microbial agents are being resistant. Microorganisms' drug resistance ability is considered a growing health problem in the treatment of infectious diseases (Prah et al, 2019). Again the lifestyle of people may be another reason for being affected by UTI.…”

A Case of Renal Inflammatory Pseudotumor Leading to Nephrectomy

“…Urinalysis showed no red blood cells and 2 to 4 white blood cells per high-power field (HPF); the normal range of white blood cells is <5 cells per HPF. 6 An abdominal computed tomography (CT) scan was performed. Pre-contrast images showed right renal enlargement with homogenous renal parenchyma ( Figure 1 ).…”