Department of Medical Laboratory Science, College of Medicine and Health Science, Samara University, Samara, Ethiopia.
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
PLoS One. 2023 Nov 29;18(11):e0276033. doi: 10.1371/journal.pone.0276033. eCollection 2023.
Asymptomatic urinary tract infection (asymptomatic bacteriuria and asymptomatic candiduria) may not be routinely detected in sexually active non-pregnant female population at the initial and reversible stages. This is mainly due to the fact that most women may not feel compelled to seek medical attention.
The aim of this study was to determine the prevalence, and factors associated with urinary tract infection (UTI), and antibiogram of the uropathogen isolates among asymptomatic female college students.
An institutional-based cross-sectional study was conducted at selected colleges in Dessie from January 2021-March 2021. A total of 422 reproductive age (15 to 49 years) non-pregnant female students were included. Socio-demographic and clinical characteristics data were collected using structured questionnaires. Ten mLs of freshly voided mid-stream urine specimen was collected, transported and processed according to the standard operating procedures. Data were coded and entered for statistical analysis using SPSS version 22.0. Descriptive statistics, bivariate and multivariate logistic regression analysis were performed and p-values <0.05 with the corresponding 95% confidence interval (CI) were considered statistically significant.
The overall prevalence of UTI was 24.6%. The prevalence of asymptomatic UTI bacteriuria and candiduria was 57 (13.5%) and 47 (11.1%), respectively. The predominant uropathogens were Staphylococcus saprophyticus 24 (23.1%), followed by Candida tropicalis 23 (22.1%), Candida albican 10 (9.6%), Candida krusei 9 (8.7%) and Escherichia coli 8 (7.7%). Gram negative bacterial isolates showed a higher level of resistance to amoxicillin-clavulanic acid 24 (92.3%). Gram positive bacterial uropathogens showed high level of resistance to penicillin 28 (96.6%) and trimethoprim-sulfamethoxazole 23 (79.3%). Gram positive bacterial isolates were sensitive to norfloxacin, clindamycin, and ciprofloxacin, accounting for 24 (82.7%), 20 (69.0%), and 19 (65.5%), respectively. Multidrug resistance was seen in 50 (87.7%) of bacterial uropathogens. Factors identified for acquisition of UTI were frequency of sexual intercourse (≥3 per week) (AOR = 7.91, 95% CI: (2.92, 21.42), and genital area washing habit (during defecation (AOR = 5.91, 95%CI: (1.86, 18.81) and every morning (AOR = 6.13, 95%CI: (1.60, 23.45)).
A significant prevalence of uropathogens, and high resistance of bacterial isolates to the commonly prescribed drugs were detected. Therefore, routine UTI screening, regular health education on the risk of asymptomatic infectious diseases for reproductive age group females, and antimicrobial susceptibility testing should be practiced to avoid the progression of an asymptomatic infection into a symptomatic UTI.
在初始和可逆阶段，活跃的非妊娠女性人群中可能不会常规检测无症状性尿路感染（无症状性菌尿症和无症状性念珠菌尿症）。这主要是因为大多数女性可能没有感到有必要寻求医疗。
本研究旨在确定无症状性女大学生尿路感染（UTI）的患病率、相关因素以及尿病原体分离株的抗生素耐药谱。
这是一项于 2021 年 1 月至 3 月在德西选定的学院进行的基于机构的横断面研究。共纳入 422 名生殖年龄（15 至 49 岁）的非妊娠女学生。使用结构化问卷收集社会人口统计学和临床特征数据。采集 10mL 新鲜排空的中段尿液标本，按照标准操作程序进行运输和处理。使用 SPSS 版本 22.0 对数据进行编码和输入进行统计分析。采用描述性统计、双变量和多变量逻辑回归分析，p 值<0.05，相应的 95%置信区间（CI）被认为具有统计学意义。
UTI 的总体患病率为 24.6%。无症状性 UTI 菌尿症和念珠菌尿症的患病率分别为 57 例（13.5%）和 47 例（11.1%）。主要的尿路病原体是腐生葡萄球菌 24 株（23.1%），其次是热带假丝酵母 23 株（22.1%）、白假丝酵母 10 株（9.6%）、近平滑假丝酵母 9 株（8.7%）和大肠埃希菌 8 株（7.7%）。革兰氏阴性菌分离株对阿莫西林克拉维酸的耐药率较高，为 24（92.3%）。革兰氏阳性菌尿路病原体对青霉素的耐药率较高，为 28（96.6%）和甲氧苄啶-磺胺甲恶唑 23（79.3%）。革兰氏阳性菌分离株对诺氟沙星、克林霉素和环丙沙星敏感，分别为 24（82.7%）、20（69.0%）和 19（65.5%）。50（87.7%）株细菌尿病原体表现出多药耐药性。获得 UTI 的因素包括性交频率（≥3 次/周）（AOR=7.91，95%CI：（2.92，21.42））和生殖器区域清洗习惯（排便时（AOR=5.91，95%CI：（1.86，18.81））和每天早上（AOR=6.13，95%CI：（1.60，23.45））。
检测到尿病原体的显著流行率，以及细菌分离株对常用药物的高度耐药性。因此，应常规进行 UTI 筛查，定期对生殖年龄组女性进行无症状性传染病风险的健康教育，并进行抗菌药物敏感性试验，以避免无症状感染发展为有症状性 UTI。
