Bacterial Uropathogens isolated from Alkaline Urine and their Susceptibility to Antimicrobial Agents Fiasal Ghofran1,*, Al-Duliami Abbas A.1, Jaafar Ali M.2, Hasan Abdulrazak SH.1 1Department of Microbiol, College of Medicine, Diyala University-Diyala, Iraq 2Department of Medicine, College of Medicine, Diyala University-Diyala, Iraq *Corresponding Author: Ghofran Fiasal, M. Sc. Department of Microbiol, College of Medicine, Diyala University, Diyala, Iraq, Phone: 00964-7702597792, Email: Alimussa1971@yahoo.com
Online published on 13 November, 2019. Abstract Background Urinary tract infection (UTI) is the most common urologic disorder. The normal urine pH is average of 6.2. UTIs or bacteriuria are among the causes shifting the urine pH to word alkalinity. Objectives Isolation and identification of bacterial uropathogens from alkaline urine and to assess their susceptibility to commonly available antimicrobial agents. Patients and Method This cross-sectional study was conducted in Baquba for the period from September 2016-November 2017. Patients were attending Baquba Teaching Hospital and Al-Batool Teaching Hospital for Maternity and Children complaining of urinary tract infection. A total of 250 patients were included. The age range was 5–50 years. 218 (87.2%) were female and 32 (12.8%) were males. Mid-stream urine samples were collected in sterile containers. General urine examination including measurement of pH was done. All samples were aseptically cultured on blood and MacConkey agar plates which were incubated at 37°C for overnight. Identification of bacterial growth was based on cultural, microscopical and biochemical criteria. The Kirby-Bauer disk diffusion technique was used to determine the bacterial susceptibility to Amoxacillin, Gentamycin, Doxycycline, Nalidixic acid, Tobramycin, Azithromycin, Ciprofloxacin, Cefotaxim, Trimethprime-sulfamethoxazol and Phosphomycin antimicrobials according to CLSI, version 2012. The MIC of all bacterial isolates against Ciprofloxacin and Azithromycin was determined according to the CLIC, version 2014. Human privacy was respected by taken participant's oral consent. Statistical analyses were done using the SPSS, Version 21and P values were considered significant wherever it is less than 0.05. Results The results found that the rate of alkaline urine among patients with UTI was 11.9%. It was significantly higher in female compared to males (87.5% vs 12.5%, P = 0.0001), and the majority of patients were in the age group < 20 years. All patients had positive bacterial growth and E. coli was the predominant (28%, P < 0.05), and 45.9% of these isolates were urease producers. Except for Amoxacillin (100% efficacy), all bacterial isolates were completely resistant to Tobramycin, Gentamycin, Nalidixic acid, Cefotaxime and Phosphomycin (0% efficacy), and partially resistant to Ciprofloxacin (71.4% efficacy), Azithromycine (85.7% efficacy) and Doxycycline (57.1% efficacy). Conclusion Although the rate of alkaline urine is low, but unignorable. Bacterial isolates are generally resistant to most antimicrobials. Thus urine pH should be considered while choosing antimicrobials for treatment of patients with UTIs. Top Keywords Alkaline urine, Urine PH, Urease producers. Top |