Abstract

We described the antimicrobial susceptibility pattern of pathogenic bacteria causing urinary tract infections among males with lower urinary tract obstruction (LUTO) at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Between January and December 2009, a cross sectional hospital based study was conducted for 102 subjects. Patients presenting with symptoms of LUTO and who were on short admission (at most 48 h) at the accident and emergency unit of KATH were identified as potential study subjects. All the patients presented with acute retention of urine at the emergency unit of KATH and urethral catheterization was attempted to relieve them of the retention under sterile conditions. Urine specimen were collected into sterile urine containers immediately after the catheterization (irrespective of type) and sent to the microbiology laboratory at KATH for routine examination, culture and antimicrobial sensitivity testing. The mean age for males with LUTO was 62 years (Range: 2-93 years). The overall prevalence of pathogens was highest among the >70 years age group (40.2%). Whilst Klebsiella spp. (43.5%) and Pseudomonas spp. (50.0%) were the most predominant species within the >70 years age group, Escherichia coli (45.3%) and Staphylococcus aureus (57.1%) were the most predominant species within the <50 and 50-70 age groups. With respect to antibiotic sensitivity, Salmonella spp. showed the highest susceptibility rate of 15.8% whilst Klebsiella spp. was the least susceptible (9.2%) to antimicrobial agents used. The highest and least multi-drug susceptible bacterial isolates were E. coli and Citrobacter freundii respectively. This study’s results indicate that antibiotics commonly used in UTIs are still effective, but species distribution and their susceptibility to antibiotics are changing. The caution therefore is that antimicrobial susceptibility testing needs to be done to help select the appropriate antibiotic for effective treatment of diseases.

Key words: Antibiotic, asymptomatic, bacteriuria, acute, cystitis, urosepsis, catheter, antimicrobial susceptibility.