Prevalence of Urinary Tract Infection in Patients Undergoing Pelvic Radiotherapy at a Teaching Hospital in Lagos, Nigeria
AbstractBackground: Radiation therapy is known to induce the breakdown of certain body defence factors. In the patient who has carcinoma of the cervix, pelvic radiotherapy increases the risk of infection with both opportunistic and pathogenic agents,.
Objectives: This study was done to determine the prevalence of urinary tract infections in patients undergoing pelvic radiotherapy for carcinoma of the cervix at the Lagos University Teaching Hospital (LUTH) Idi-araba, and to isolate and identify the causative agents, and determine their antimicrobial sensitivity patterns.
Methods: Between January and September 2001, mid-stream urine samples were collected from all patients on pelvic radiotherapy for Carcinoma of the cervix and other categories of persons who served as controls. These were immunosuppressed patients like Diabetes mellitus patients, HIV/AIDS patients, and healthy volunteers. Microscopy, culture and sensitivity of their urine samples were performed by standard laboratory methods.
Result: Sixty-four women with age range 30-59 years underwent pelvic radiotherapy during the period of study. The prevalence rate for urinary tract infection was found to be 20.3%. The predominant isolates were Escherichia.coli (23.1%) and Klebsiella pneumoniae (23.1%). Many of the gram-positive isolates were sensitive to amoxycillin-clavulanic acid 62.5%) and gentamicin (55%), but showed reduced sensitivity to ampicillin (0%), chloramphenicol (22.22%) and co-trimoxazole (25%). The Gram negative bacilli were completely resistant to amoxycillin-clavulanic acid(0%), ampicillin (0%) and showed low susceptibility to cotrimoxazole (12.5%). Susceptibility rate to nitrofurantoin was 41.02%) and to nalidixic acid was 45%. Susceptibilities to ciprofloxacin and ofloxacin were 50% and 71.87% and to gentamicin and tobramicin were 50% and 40% respectively.
Conclusion: Antimicrobial therapy for urinary tract infection in this patient population should be based on the results of culture and sensitivity. There is need for antibiotic surveillance of urinary pathogens so that therapy can be based on judicious use of antibiotics and antibiotic policies.
Jnl of Nigerian Infection Control Association Vol.4(1) 2001:6-10