Bacterial Profile and Antimicrobial Sensitivity Patterns in Asymptomatic Bacteriuria: A Cross-sectional Study of Sickle Cell Disease Patients in the Ho Municipality, Ghana

Abstract

Background: Sickle cell disease (SCD) patients are vulnerable to asymptomatic urinary tract infection (UTI), and this can lead to long lasting kidney problems. Aim: This cross-sectional study assessed the bacterial profile and examined the sensitivity patterns of the isolated bacteria among the SCD patients. Methods: From January 2014 to April 2014, Seventy-one (71) patients were consecutively sampled from the sickle cell clinic of Volta Regional Hospital, Ho-Ghana. Mid-stream urine samples were collected for culture and sensitivity. Bacteria isolated were identified and tested for their antimicrobial sensitivity patterns using the Kirby-Bauer disc diffusion method. Independent t-test, Pearson Chi‑square test and ANOVA were used to determine mean, standard deviations, associations and differences in groups. P value < 0.05 was considered statistically significant. Results: The study showed a bacteria profile of Escherichia coli, Staphylococus aureus and Citrobacter spp among the SCD participants. Antimicrobial sensitivity patterns depicted Escherichia coli as sensitive to nitrofurantoin and gentamicin while Citrobacter spp. was sensitive to Nitrofurantoin. Staphylococus aureus was sensitive to cotrimoxazole with all three isolates resistant to ampicillin. 8.5% of the participants had asymptomatic bacteriuria (ASB) and was more in females (66.7%) than in males (33.3%) and in SS genotype (83.3%) than in SC genotype (16.7%). Conclusion: The research found the prevalence of ASB among SCD patients to be most common in females and SS genotypes. Escherichia coli was the predominant isolate and this isolate was susceptible to nitrofurantoin but highly resistant to ampicillin. Urine culture and sensitivity should be included in the clinical assessments of SCD patients and education and awareness on the importance of personal hygiene, particularly in sickle cell disease patients should also be encouraged.