Correlating Urinary Tract Infection with Patients’ Presenting Symptoms and Bacterial Isolation from Urine in Uyo, Nigeria

Abstract

Background: In clinical practice, diagnosis of urinary tract infection (UTI) ideally involves the presence of symptoms and a positive urine culture results. However, due to lack of laboratory facility and where present, delays in getting laboratory result encountered by attending outpatient Physicians, diagnosis are made from presenting symptoms in patients. Empirical treatments are commenced with expectation of positive outcome. Objectives: The aim of this study was to correlate Urinary tract infection with presenting symptoms in patients and laboratory culture results from mid-stream urine samples in Uyo, Nigeria. Materials and Methods: This six months descriptive cross sectional study was carried out in the outpatient Department of the University of Uyo Teaching Hospital in Uyo. Data was obtained through questionnaire administered on 370 consenting outpatients and laboratory culture results from collected midstream urine were analyzed using SPSS software (version 20.0). The predisposing risk factors in these patient were also assessed. The midstream urine samples from the subjects were standardly processed. Cultured urine samples that yielded Gram negative uropathogens were further identified using Microbact 24E (Oxoid, UK), while those that yielded Gram positive uropathogens were identified by the appropriate standard procedures. Results: The presenting symptoms were; discomfort when urinating, urge incontinence (7.6%), frequent urination (11.9%), and cloudy urine with foul smell (8.1%), malaise (23.8%), fever (23.5%), back/flank pain (3.8%) and hematuria (4.6%) (P<0.001). The attendant risks factors assessed were age, gender, cleaning method after urination/defecation, contraceptive use, diabetes, past history of UTI and recent catheter use (P<0.05). Female outpatients had more laboratory confirmed UTI (25.9%) than male outpatients (11.5%). Also revealed is the fact that there is higher prevalence of UTI in female outpatients within the reproductive age group of 28-37 years (43.8%). Conclusion: In this study, less than 30% of female patients with presenting symptoms of UTI had positive urine culture test result while only about 12% of males with these symptoms are culture positive for UTI in Uyo, Akwa Ibom State, Nigeria.