Prevalence of Symptomatic Bacteriuria and Associated Risk Factors among Patients Attending Major Hospitals in Calabar, Nigeria

ABSTRACT Introduction Urinary tract infections (UTIs) are among the most encountered bacterial infection of humans and affect both male and female of all age groups, resulting in high mortality of infected patients if not properly managed. Hypothesis/Gap statement Several studies in different sub-Saharan Africa locations show variations in incidence of UTI as well as it’s causative organisms. Aim This study aimed to assess the prevalence, etiological agents, and factors associated with urinary tract infections among patients attending selected hospitals in Calabar metropolis, Nigeria. Methodology This was a cross-sectional study. Mid-stream urine samples collected from 240 patients with UTI were cultured using Cystine Lactose Electrolyte Deficient Agar (CLED). Data on socio-demographic, clinical symptoms and risk factors were obtained using structured questionnaire. Uropathogens were characterized using microbiological and biochemical tests and confirmed with API ® 20E and 20NE (Biomérieux) identification system. Pearson Chi-square was employed to check associations between categorical variables. P -value of <.05 was considered statistically significant. Results Out of the 240 urine samples collected, 13 were contaminated during collection, and 227 analyzed. Sixty-five (28.6%) patients had significant bacteriuria. Previous history of UTI ( P =.000, CI=1.582-5.180), use of drugs without prescription ( P =.000, CI=0.040-0.220), pregnancy ( P =.001, CI=1.858-12.575) and history of urinary catheter ( P =.031, CI=1.024-19.053) showed significant association with the occurrence of UTI. Klebsiella pneumoniae (23.1%) was the most predominant isolate, followed by Coagulase-negative Staphylococci (16.9%) and Escherichia coli (12.3%). Conclusion The study shows that routine UTI screening is beneficial for pregnant women, patients with difficult or painful urination, patients with previous episodes of UTI, catheterized patients and appropriate drugs administered for positive cases. In addition, self-administration of antibiotics should be avoided.