Prevalence and Associated Uropathogens among Apparently Healthy Students of a Tertiary Institution in South-East, Nigeria

Abstract

Background: Urinary Tract Infections (UTIs) are one of the most severe public health problems encountered, caused by a range of pathogens mostly bacteria, and others like yeast and mould. The infection could start as cystitis, disseminate to pyelonephritis and could result to complications like renal failure or septicaemia. UTI prevalence and associated uropathogens vary worldwide. Aim: This study was undertaken to determine the prevalence and uropathogens that are responsible for UTI among apparently healthy undergraduates of a university in South-Eastern Nigeria. Methodology: Study design: Descriptive cross sectional study. Place and duration of study: Department of Microbiology, Renaissance University Ugbawka, Enugu State, Nigeria; between May to July, 2024. Stratified random sampling, to get a total of 460 students (209 males and 251 females) who were randomly selected and gave their informed consent. Freshly voided midstream early morning urine specimens were collected and examined with standard Microbiological cultural methods. The uropathogens were identified using standard microbiological and molecular methods. Statistical analysis was done using percentages and Chi square tests on Statistical Package for Social Sciences (SPSS) version 22 and P-value set at ≤0.05. Results: A total of 170 specimens (37%) had positive urine cultures with 148(32.2%) and 22(4.8%) specimens that showed monomicrobial and polymicrobial growth. Non- significant growth was observed in 175(38%) specimens while 115(25%) specimens showed no growth. The uropathogens isolated from female students 125(64.4%) were higher compared to males 69(35.6%) and there is a significant association between the characteristic growth patterns and sex of the study participants (P-value =0.001). The most predominant bacterium was Klebsiella pneumoniae 34(17.6%), followed by Escherichia coli 29(5.0%), Staphylococcus aureus 19(9.8%) among others. Other rare UTI bacteria pathogens isolated include: Providencia alcalifaciens 3(1.6%), Klebsiella quasipneumoniae 2(1.0%) and Enterobacter hormaechei 1(0.5%). Candida albicans 12(6.2%) and Lichteimia species 9(4.6%) were the most occurring yeast and mould isolates. Conclusion: The high prevalence and wide range of uropathogens observed in this study suggest that compulsory UTI screening should be conducted among the students especially at the entry level to the university; to ensure early detection of asymptomatic UTI.