Prevalence and antimicrobial sensitivity of asymptomatic bacteriuria among sickle cell anaemia patients in Aminu Kano Teaching Hospital, Nigeria

Abstract

Introduction: Urinary tract infection (UTI) is a common cause of morbidity in children with sickle cell anaemia (SCA) and may present as asymptomatic bacteriuria. Asymptomatic bacteriuria is often under-diagnosed and may lead to long term renal complications.

Aim: This study compared the prevalence of asymptomatic bacteriuria, bacterial isolates and their antimicrobial sensitivity in children with and without SCA seen at Aminu Kano Teaching Hospital.

Subjects and Methods: This cross-sectional study recruited 139 children with SCA in stable state and 139 children without SCA aged 1- 15 years. All children were tested for asymptomatic bacteriuria using clean catch or mid-stream urine samples. Children whose samples yielded significant bacteriuria (≥105cfu/ml) had a repeat urine culture within a week to confirm asymptomatic bacteriuria.

Results: Both study groups had a mean age of 4.25 years ± 3.04, and a male: female ratio of 1.4:1. The prevalence of asymptomatic bacteriuria was higher in children with SCA(5.8%) compared to children without SCA (1.4%). Asymptomatic bacteriuria was more common among females in both study groups. The most common isolate in both groups was E. coli. Majority of the isolates were sensitive to quinolones, gentamycin and nitrofurantoin but resistant to commonly used antibiotics like amoxicillin and cotrimoxazole.

Conclusion: Asymptomatic bacteriuria is more common in children with SCA than those without SCA. Majority of isolated pathogens showed low susceptibility to ampicillin, amoxicillin, cotrimoxazole and nalidixic acid, this implies that the use of these drugs for empirical or first line treatment for UTI in children with SCA should be avoided.