Prevalence and Antibiotic Susceptibility Profiles of Klebsiella pneumoniae and Escherichia coli in Asymptomatic Urinary Tract Infection among University Students in Ebonyi State, Nigeria

Abstract

Background: Klebsiella pneumoniae and Escherichia coli are among the commonest causes of urinary tract infection (UTI) in all ages with notorious antibiotic resistance. The peculiar substandard conditions of living of most undergraduate students in tertiary institutions make them a high-risk group for UTI both symptomatic and asymptomatic. Aim: The aim of this study was to determine prevalence and antibiotic susceptibility profiles of Klebsiella pneumoniae and Escherichia coli in asymptomatic urinary tract infection among university students in Ebonyi State, Nigeria. Methodology: Standard microbiological methods were strictly followed in the collection and analysis of the samples while antibiotic susceptibility profiles of the bacterial isolates were carried using Kirby Bauer disk diffusion methods. Results: Of the total 60 urine samples collected, the total prevalence of uropathogenic K. pneumoniae and E. coli was 15(25 %) and 31(51.7 %) respectively. Female students had the highest prevalence of K. pneumoniae 11(36.7 %) and E. coli 20(66.7 %) compared to their male counterpart with K. pneumoniae 4(13.3 %) and E. coli 11(36.7 %). The results of antibiotic susceptibility studies revealed that from the male students, K. pneumoniae were mostly susceptible to imipenem 4(100%), ceftriaxone 3(100%) and cefuroxime 3(75%) but showed high resistance to piperacillin/Tazobactam 4(100%) and polymyxin B 4(100%) while E. coli isolates were susceptible to imipenem 11(100%), cefuroxime 8(73%) and cefoxitin 7(64%) while being resistant to polymyxin B 11(100%), piperacillin/Tazobactam 11(90%) and cefotaxime 8(73%). On the otherhand from the female students, antibiotic susceptibility studies revealed that K. pneumoniae were susceptibility to imipenem 11(100%), amoxicillin-clavulanic acid 7(64%), cefuroxime 6(55%) and showed increased resistance to piperacillin/tazobactam 11(100%), polymyxin B 11(100%) and ciprofloxacin 8(73%). Conclusion: Imipenem was found to be the most effective antibiotics for treatment of UTI caused by K. pneumoniae and E. coli. Continuous strategic surveillance and antibiotic stewardship of asymptomatic uropathogens, to effectively manage and monitor resistance trends of UTIs in order to provide guided treatment options for UTI cases are highly recommended.