Magnitude and antibiogram of uropathogens and associated risk factors among asymptomatic female college students in Dessie town, Northeast Ethiopia

Abstract

Background: Asymptomatic Urinary Tract Infection (Asymptomatic bacteriuria and asymptomatic candiduria) in sexually active non-pregnant female’s population in most cases may not be routinely detected at the initial and reversible stages. This is due to the fact that most women may not feel compelled to seek medical help. Objectives: to determine the prevalence, and factors associated with asymptomatic urinary tract infection, and antibiogram of the uropathogen isolates among asymptomatic female college students Methods: An institutional based cross-sectional study was conducted at selected colleges found in Dessie from January 2021 to March 2021. A total of 422 reproductive age non-pregnant female students were included and socio-demographic and clinical characteristics data were collected using structured questionnaires. Ten ml freshly voided mid-stream urine specimen was collected, transported and processed according to standard operating procedure. Data were coded and entered for statistical analysis using SPSS version 22.0 and descriptive statistics, bivariate and multivariate logistic regression analysis were performed. P-value ≤0.05 with corresponding 95% confidence interval (CI) were considered statistically significant. Result: The overall prevalence of UTI was 24.6%. The prevalence of asymptomatic UTI bacteriuria and candidiuria were 57 (13.5%) and 47 (11.1%) respectively. The predominant isolated uropathogens were S. saprophyticus 24 (23.07%) followed by Candida tropicalis 23 (22.1%), Candida albican 10 (9.61%), Candida krusei 9(8.65%) and E. coli 8 (7.69%). Gram negative bacterial isolates showed higher level of resistance to Amoxicillin-clavulanic acid 24 (92.3%). Gram positive bacterial uropathogens showed high level of resistance for penicillin 28 (96.6%) and Trimethoprim-Sulfamethoxazole 23 (79.3%). Gram positive bacterial isolates were sensitive to norfloxacin clindamycin and ciprofloxacin accounting 24 (82.7%), 20 (69.0%) and 19 (65.5%), respectively. Moreover, MDR was seen in 50 (87.7%) of all isolated bacterial uropathogens. Frequency of sexual intercourse ( > 3 per week) (AOR =7.907, 95% CI: (2.918, 21.425), (P=0.000) and genital area washing habit (during defecation) (AOR = 5.914, 95%CI: (1.860, 18.809), (P=0.0003) and every morning (AOR = 6.128, 95%CI: (1.602, 23.449), (P=0.0008) were found to have statistically significant association with the occurrence of UTI among asymptomatic female college students. Conclusion: A significant prevalence of uropathogens, and high resistance of bacterial isolates to commonly prescribed drugs were observed. Therefore, routine UTI screening, regular health education on the risk of asymptomatic infectious diseases and antimicrobial susceptibility testing should be practiced to avoid the progression of asymptomatic infection into symptomatic UTI.