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Category: Volume 06 Issue 04 April 2018
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Title: Bacterial Pattern and Risk Factors Associated with Urinary Tract Infection in Secondary School Going Girls in Dhaka City

Authors: Dr. Md Asaduzzaman, Dr. Md Abdur Rouf, Dr. Md Mozibur Rahman, Dr. Md Kamrul Ahsan Khan, Dr. Md Shafiqul Islam, Dr. Md Habibur Rahman, Dr. Wahida Khanam, Dr. Tahmina Afreen Daisy, Dr. M A Mannan

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i4.188

Abstract

Background: Urinary tract infection is one of the most common bacterial infection in children. During adolescence, the incidence of UTI increases significantly in young women while remain constant in young men. Asymptomatic bacteriuria is also more common in female. Antibiotic resistance has become an important factor to be considered in the treatment of UTI. There are several risk factors of UTI in both symptomatic and asymptomatic bacteriuria in school going girls in these age group.

Materials & Methods: Midstream urine samples were collected from 200 school going girls of four secondary school spreading in four Thana of Dhaka city by random sampling. Each specimen was cultured on Mac Conkeys and Chromogenic media including microscopic examination. The inoculated plates were incubated at 37OC aerobically for 24 hours. Antibiotic susceptibility testing of the isolates was also assessed. Risk factors like toilet training (wiping back to front), voiding during school time, incomplete evacuation, constipation, using unhygienic menstrual cloth during menstruation and tight jeans were evaluated.

Results: Prevalence of UTI was 9% of culture positive 18 cases with significant colony count > 105/ml. Among them 4% were symptomatic UTI and 5% were asymptomatic bacteruria. Esch. coli was found to be the most predominant pathogen 44% followed by Klebsiella spp. (17%), Enterobacter spp. (17%), Enterococci spp. (17%) and Proteus spp.(5%). Amoxycillin, cotrimoxazole and cephradine were the common resistant antibacterial agent among isolates. There was significant association of UTI with risk factors like toilet training (wiping back to front), constipation, using unhygienic cloth during menstruation and wearing tight pants (Jeans).

Conclusion: Frequency of UTI was 9% in secondary school going girls. Among them 4% were symptomatic UTI and 5% were asymptomatic bacteriuria. Risk factors like toilet training (wiping from back to front), constipation, unhygienic sanitary cloth during menstruation and using tight jeans pant were associated with UTI. Gram negative bacteria were more common and there were high level of resistance to Amoxycillin, cotrimoxazole and cephradine of the isolated organism.

Keywords: Bacterial pattern, risk factors, UTI, secondary school girls.

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Corresponding Author

Dr. Md. Asaduzzaman

Consultant (Pediatrics), Central Police Hospital Dhaka