asymptomatic, bacteriuria, female, students, university
J Olaitan. Asymptomatic Bacteriuria In Female Students Population Of A Nigerian University. The Internet Journal of Microbiology. 2005 Volume 2 Number 2.
The term 'bacteriuria' means the presence of bacteria in urine. It may results from contamination during or after collection of urine or it may indicate the presence of bacteria in bladder urine. To distinguish among these possibilities; Kass1 introduced the term “significant bacteriuria” which was defined as the occurrence of 105 or more bacteria per ml of a voided midstream urine aseptically collected. Bacteriuria can be divided into symptomatic and asymptomatic. Asymptomatic bacteriuria refers to the presence and multiplication of bacteria in the bladder urine in the absence of symptoms of urinary tract infection while symptoms are present in symptomatic cases3.
Bacterial infections of the urinary tract are commonly seen in outpatients, hospitalised patients and apparently healthy populations. Asymptomatic bacteriuria occurred reliably more frequently in females as compared with males and it is a major criterion of urinary tract infection(UTI)14. Reasons adduced to this include shorter and wider urethra and its proximity to the anus. It was therefore thought necessary to investigate incidence of asymptomatic bacteriuria in female undergraduate students and also to study the effects of commonly used antibiotics on the bacteria isolated.
Materials And Methods
Three hundred healthy asymptomatic undergraduate students of Lagos State University between ages of 16 and 26 were randomly sampled. Students with any symptom suggestive of urinary tract infection or those who have taken antibiotics two weeks before or were currently on antibiotics, or pregnant were excluded from the study. Midstream urine samples were collected from clinically healthy female students into sterile universal bottles. The samples were examined immediately or refrigerated (4°C) and examined within 6 hours of collection.
Each of the urine samples (5ml.) was centrifuged for 1min and examined under the microscope (Griffin model) for the presence of yeast cells, parasites, leucocytes, erythrocytes and granular casts.
Each specimen was cultured on MacConkey agar and Blood agar. The inoculated plates were incubated (using Gallenkamp model cooled incubator) at 37°C aerobically for 24hours. Those without growth were re-incubated for an additional 24hours. Samples with 105 or more bacteria per ml were recorded as showing significant bacteriuria. Bacterial species were identified according to standard bacteriological tests.
Pure isolates were tested by the plate diffusion method for antibiotic susceptibility on the Diagnostic Sensitivity Teat (DST) agar (OXOID CM26) with antibiotic disc. The sensitivity plates were incubated aerobically for 18hours and the zone of inhibition was noted.
The colour of the urine samples ranged from colourless, straw, to turbid. From the microscopic examination, 18 samples contained epithelial cells, 7 samples, leucocytes, 16 samples, yeast cells, 3 samples, granular casts and crystals. No
The result of the sensitivity test (Table3) showed that
The term 'bacteriuria' means the presence of bacteria in urine. Bacteriuria can be divided into symptomatic and asymptomatic. Asymptomatic bacteriuria refers to the presence and multiplication of bacteria in the bladder urine in the absence of symptoms of urinary infection while symptoms are present in symptomatic cases3. Urinary tract bacterial infections are common in women. Moreover, they tend to recur throughout life and in the same relatively small group of women. In some instances, however, especially with frequent sexual activity, pregnancy, stone disease, or diabetes, symptomatic cystitis or pyelonephritis develops and antimicrobial therapy is indicated4.
Asymptomatic bacteriuria is a common finding, and past history of symptoms such as frequency and dysuria is common5. Akinkugbe
It has also been reported that bacteriuria is common among women probably due to the proximity of female urethra to the anus, its short length and its termination beneath the labia10. It has been observed that bacteriuria in young girls and women is preceeded by colonisation of the vaginal introitus by the specific species of Enterobacteriaceae that produces the infection. Adhesion property of the bacteria is an important factor that mediate the ability of a bacterial species to colonise the vaginal or any mucosal surface.
Bacteria associated with bacteriuria in asymptomatic female in this study are
It accounts for 47% of all isolates, whereas in general practice it accounts for more than 90% hence most work on the pathogenesis of urinary tract infection has focused on this micro-organism.
The current study shows a 10% incidence of significant bacteriuria. This value is higher than 5% incidence bacteriuria among students of secondary schools7 and females of 14-17year of age with 3.3% bacteriuria11. The higher value obtained could be possibly due to increase in sexual activities among the University age group and /or increased age compared to the secondary school students. The age of the students screened ranges between 16 and 26 compared to less than 16 years of secondary school age. The value of 1.4-2.1% obtained in Europe13 several years ago was much lower than our current report. This may be attributed to the difference in socio-economic and hygiene levels of the people. Asymptomatic bacteriuria occurred reliably more frequently in females as compared with males and it is a major criterion of urinary tract infection(UTI)14.
Other bacteria isolated from this study included
Co-trimoxazole and Nitrofurantoin were very effective against
The high prevalence of resistance to the commonly used antibiotics such as Ampicilllin and Tetracycline has caused considerable alarm. This may be due to failure to control the sale and restrict the use of antibiotics in our community.
In conclusion, while improved level of hygiene is likely to assist in reducing asymptomatic bacteriuria which may be complicated by urinary tract infection, the general pubic should be educated on the danger in taking unprescribed drugs and therefore stop indiscriminate use of antibiotics. The sale of such drugs as antibiotics must be restricted to physician's prescription. The female should always clean from forward to backward after using the toilet so as not to transfer the microorganisms from the bowel to the vagina. These will help in reducing the high rate of asymtomatic bacteriuria among our university female students.