Urinary tract infection among obstetric fistula patients at Gondar University Hospital, Northwest Ethiopia

Abstract

BackgroundMany women die from complications related to pregnancy and childbirth. In developing countries particularly in sub-Saharan Africa and Asia, where access to emergency obstetrical care is often limited, obstetric fistula usually occurs as a result of prolonged obstructed labour. Obstetric fistula patients have many social and health related problems like urinary tract infections (UTIs). Despite this reality there was limited data on prevalence UTIs on those patients in Ethiopia. Therefore, the aim of this study was to determine the prevalence, drug susceptibility pattern and associated risk factors of UTI among obstetric fistula patients at Gondar University Hospital, Northwest Ethiopia.MethodsA cross sectional study was conducted from January to May, 2013 at Gondar University Hospital. From each post repair obstetric fistula patients, socio-demographic and UTIs associated risk factors were collected by using a structured questionnaire. After the removal of their catheters, the mid-stream urine was collected and cultured on CLED. After overnight incubation, significant bacteriuria was sub-cultured on Blood Agar Plate (BAP) and MacConkey (MAC). The bacterial species were identified by series of biochemical tests. Antibiotic susceptibility test was done by disc diffusion method. Data was entered and analyzed by using SPSS version 20.ResultsA total of 53 post repair obstetric fistula patients were included for the determination of bacterial isolate and 28 (52.8%) of them had significant bacteriuria. Majority of the bacterial isolates, 26 (92.9%), were gram negative bacteria and the predominant ones were Citrobacter 13 (24.5%) and E. coli 6 (11.3%). Enterobacter, E.coli and Proteus mirabilis were 100% resistant to tetracycline. Enterobacter, Proteus mirabilis, Klebsella pneumonia, Klebsella ozenae and Staphylococcus aureus were also 100% resistant to ceftriaxone.ConclusionThe prevalence of bacterial isolates in obstetric fistula patients was high and majority of the isolates were gram negative bacteria. Even thought the predominant bacterial isolates were Citrobacter and E. coli, all of the bacterial isolates had multiple antibiotic resistance patterns which alert health profession to look better treatment for these patients.

Bacteriological profile, risk factors and antimicrobial susceptibility patterns of symptomatic urinary tract infection among students of Mekelle University, northern Ethiopia

“…In line with earlier documented findings [2, 39, 48]; age and history of antibiotics had no association with UTI in the present study. Moreover, contrary to the previous report [46] the present study revealed, using contraceptives, circumcision and having diabetics’ Mellitus had no significant association with the presence of UTI.…”

Urinary tract infection among fistula patients admitted at Hamlin fistula hospital, Addis Ababa, Ethiopia

“…According to previous study done in West Ethiopia Citrobacter (24.5%) [ 24 ] was the most dominant bacterial isolated while in this study Citrobacter was not isolated and Escherichia coli (53.7%) was the most dominant isolated similar to other many studies (39%, 44.9%, 31.7 %) respectively [ 19 , 27 , 28 ].…”

“…Lower report was also reported from other African country Tanzania [ 18 ] and Nigeria (47.5%) [ 22 ]. The prevalence of present study was also higher than other reports from Ethiopia; North West Ethiopia [ 23 ]; (52.8%) [ 24 ], Addis Ababa [ 25 ] and Dessie [ 26 ].…”

Non-Fistulous Complications of Prolonged Obstructed Labour among Obstetric Fistula Patients in Southern Nigeria

“…Urinary tract infection was seen in 61.5% of participants. The proportion of women with UTI is much higher than 26.2% reported in Sokoto [16], but similar to findings of 52.8% and 58.1% in Ethiopia [28] [29]. Circumferential defect, urethral involvement and extensive vaginal scarring predict poor prognosis of surgical outcomes of obstetric fistula repair [30] [31].…”