Share This Article:

Bacterial Urinary Tract Infections among Males with Lower Urinary Tract Obstruction at Komfo Anokye Teaching Hos-pital, Kumasi, Ghana

Full-Text HTML Download Download as PDF (Size:214KB) PP. 131-136
DOI: 10.4236/oju.2012.23023    3,466 Downloads   6,097 Views   Citations

ABSTRACT

Purpose: We describe the commonest pathology responsible for lower urinary tract obstruction (LUTO) and associated symptoms such as UTI, etc. among males at the Komfo Anokye Teaching Hospital (KATH) in Kumasi. Materials and Methods: Between January and December 2009, prospective cross sectional hospital based study was conducted involving 103 subjects. Patients with symptoms of LUTO and who were on short admission (up to 48 hours) 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. Those patients whose initial catheterization failed went through suprapubic cystostomy (suprapubic catheterization). Urine specimens for culture and sensitivity tests were then collected into sterile urine containers immediately after the catheterization (irrespective of type). Ultrasound Scan was requested for all the patients to assist in diagnosing enlargement of the prostate and other associated urological pathologies. Retrograde urethrogram was however, requested for those patients with suprapubic catheterization and which helped in the diagnosis of the urethral stricture. For a particular child, urethral catheter was passed under sterile condition and Micturicting Cysto-Urethrogram (MCUG) was done to assist in diagnosing posterior urethral valve and other conditions. Those subjects whose urinalysis revealed pyuria and positive urine culture and who had voluntarily agreed to enter the study were enrolled. Subjects whose urine culture had multiple bacteria growth that was deemed to be contaminants were excluded from the study. Results: The mean age for males with LUTO was 62 years. The youngest male with LUTO was aged 2 years whilst the maximum age was 93 years. LUTO due to prostatic hyperplasia was found in 79 (76.7%) men; 23 (22.3%) had LUTO due to urethral stricture and 1 (1.0%) (youngest male). The mean age of patients that had LUTO due to urethral stricture was approximately 39 years. The youngest patient with LUTO due to urethral stricture aged 22 years whilst the maximum age was 72 years. Microbiological results indicated that Escherichia coli caused 53 (51.5%) of urinary tract infection (UTI) due to LUTO; Klebsiella = 23 (22.3%); Staphylococcus aureus = 14 (14.6%); Pseudomonas spp. = 8 (7.8%) Proteus = 2 (2.0%); Citrobacter = 1 (1.0%) and Salmonella spp. =1 (1.0%). Conclusion: The most common cause of lower urinary tract obstruction (LUTO) in Kumasi, Ghana is prostatic hyperplasia and the commonest causative organism of the associated UTI symptom is Escherichia coli.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

C. Kofi Gyasi-Sarpong, E. Mwintiereh Ta-ang Yenli, A. Idriss, A. Appiah Arhin, K. Aboah, R. Azorliade, Y. Agyekum Boaitey and A. Angelina Annan, "Bacterial Urinary Tract Infections among Males with Lower Urinary Tract Obstruction at Komfo Anokye Teaching Hos-pital, Kumasi, Ghana," Open Journal of Urology, Vol. 2 No. 3, 2012, pp. 131-136. doi: 10.4236/oju.2012.23023.

References

[1] V. W. Nitti, “Pressure Flow Urodynamic Studies: The Gold Standard for Diagnosing Bladder Outlet Obstruction,” Reviews in Urology, Vol. 7, Suppl. 6, 2005, pp. 14-21.
[2] C. Dawson and H. Whitfield, “ABC of Urology: Bladder Outflow Obstruction,” BMJ, Vol. 312, No. 7033, 1996, pp. 767-770. Hdoi:10.1136/bmj.312.7033.767
[3] J. S. Lam, K. L. Cooper and S. A. Kaplan, “Changing Aspects in the Evaluation and Treatment of Patients with Benign Prostatic Hyperplasia,” Medical Clinics of North America, Vol. 88, No. 2, 2004, pp. 281-308. Hdoi:10.1016/S0025-7125(03)00147-0
[4] A. J. Schaeffer and E. M. Schaeffer, “Infection of the Urinary Tract,” In: A. J. Wein, et al., Eds, Campbell Walsh Urology, 9th Edition, Saunders, Philadelphia, 2007, pp. 223-303.
[5] E. H. Kass and M. Finland, “Asymptomatic Infections of the Urinary Tract,” Transactions of the American Society of Physiology, Vol. 69, 1956, pp. 56-64.
[6] T. L. Griebling, “Urinary Tract Infection in Women,” In: M. S. Litwin and C. S. Saigal, Eds., Urologic Diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, US Government Printing Office: NIH Publication, Washington DC, 2007, pp. 589-619.
[7] J. W. Warren, “Catheter-Associated Urinary Tract Infection,” Infectious Disease Clinics of North America, Vol. 11, No. 3, 1997, pp. 609-622. Hdoi:10.1016/S0891-5520(05)70376-7
[8] C. M. Kunin, “Urinary Tract Infections: Detection, Prevention, and Management,” Williams & Wilkins, Baltimore, 1997.
[9] S. M. Schappert, “Ambulatory Care Visits to Physician Offices, Hospital Outpatient Departments, and Emergency Departments: United States, 1997,” Vital and Health Statistics Series 13, No. 143, 1999, pp. 1-39.
[10] T. L. Griebling, “Urinary Tract Infection in Men,” In: M. S. Litwin and C. S. Saigal, Eds., Urologic Diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, US Government Printing Office: NIH Publication, Washington, 2007, pp. 623-645.
[11] A. L. Hidron, J. R. Edwards, J. Patel, et al., “NHSN Annual Update: Antimicrobial-Resistant Pathogens Associated with Healthcare-Associated Infections: Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007,” Infection Control and Hospital Epidemiology, Vol. 29, No. 11, 2008. Hdoi:10.1086/591861
[12] S. S. Taiwo and A. O. A. Aderounmu, “Catheter Associated Urinary Tract Infection: Aetiologic Agents and Antimicrobial Susceptibility Pattern in Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria,” African Journal of Biomedical Research, Vol. 9, 2006, pp. 141-148.
[13] C. Turpin, B. Minkah, K. Danso and E. Frimpong, “Asymptomatic Bacteriuria in Pregnant Women Attending Antenatal Clinic at Komfo Anokye Teaching Hospital, Kumasi, Ghana,” Ghana Medical Journal, Vol. 41, No. 1, 2007, pp. 26-29.
[14] M. Cheesbrough, “Parasitological Tests,” In: A. Moody, G. Malcolm and W. John, Eds., District Laboratory Practice in Tropical Countries, Vol. 1, Cambridge University Press, New York, 2009
[15] R. W. Haley, D. H. Culver, J. W. White, M. W. Morgan and T. G. Emori, “The Nationwide Nosocomial Infection Rate: A New Need for Vital Statistics,” American Journal of Epidemiology, Vol. 121, No. 2, 1985, pp. 159-67.
[16] J. P. Patton, D. B. Nash and E. Abrutyn, “Urinary Tract Infection: Economic Considerations,” Medical Clinics of North America, Vol. 75, No. 2, 1991, pp. 495-513.
[17] W. E. Stamm and T. M. Hooton, “Management of Uri- nary Tract Infections in Adults,” The New England Journal of Medicine, Vol. 329, No. 18, 1993, pp. 1328-1334. Hdoi:10.1056/NEJM199310283291808
[18] H. C. Kuo, “Clinical Prostate Score for Diagnosis of Bladder Outlet Obstruction by Prostate Measurements and Uroflowmetry,” Urology, Vol. 54, No. 1, 1999, pp. 90-96. Hdoi:10.1016/S0090-4295(99)00092-8
[19] J. Isaac and D. S. Coffey, “Etiology and Disease Process Of Benign Prostatic Hyperplasia,” Prostate, Vol. 2, 1987, pp. 33-50.
[20] D. M. Peehl, P. Cohen and R. G. Rosenfeld “The Insulin-Like Growth Factor System in the Prostate,” World Journal of Urology, Vol. 13, No. 5, 1995, pp. 306-311. Hdoi:10.1007/BF00185974
[21] R. A. Santucci, G. F. Joyce and M. Wise, “Male Urethral Stricture Disease,” The Journal of Urology, Vol. 177, No. 5, 2007, pp. 1667-1674. Hdoi:10.1016/j.juro.2007.01.041

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.