Main Article Content
Background: Sickle cell disease (SCD) patients are vulnerable to asymptomatic urinary tract infection (UTI), and this can lead to long lasting kidney problems.
Aim: This cross-sectional study assessed the bacterial profile and examined the sensitivity patterns of the isolated bacteria among the SCD patients.
Methods: From January 2014 to April 2014, Seventy-one (71) patients were consecutively sampled from the sickle cell clinic of Volta Regional Hospital, Ho-Ghana. Mid-stream urine samples were collected for culture and sensitivity. Bacteria isolated were identified and tested for their antimicrobial sensitivity patterns using the Kirby-Bauer disc diffusion method. Independent t-test, Pearson Chi‑square test and ANOVA were used to determine mean, standard deviations, associations and differences in groups. P value < 0.05 was considered statistically significant.
Results: The study showed a bacteria profile of Escherichia coli, Staphylococus aureus and Citrobacter spp among the SCD participants. Antimicrobial sensitivity patterns depicted Escherichia coli as sensitive to nitrofurantoin and gentamicin while Citrobacter spp. was sensitive to Nitrofurantoin. Staphylococus aureus was sensitive to cotrimoxazole with all three isolates resistant to ampicillin. 8.5% of the participants had asymptomatic bacteriuria (ASB) and was more in females (66.7%) than in males (33.3%) and in SS genotype (83.3%) than in SC genotype (16.7%).
Conclusion: The research found the prevalence of ASB among SCD patients to be most common in females and SS genotypes. Escherichia coli was the predominant isolate and this isolate was susceptible to nitrofurantoin but highly resistant to ampicillin. Urine culture and sensitivity should be included in the clinical assessments of SCD patients and education and awareness on the importance of personal hygiene, particularly in sickle cell disease patients should also be encouraged.
Nicolle LE. Asymptomatic bacteriuria-important or not? N Engl J Med. 2000;1037-1039.
Modell B, Darlison M. Global epidemiology of haemoglobin disorders and derived service indicators. Bulletin of the World Health Organization. 2008;86(6):480–487.
Grosse SD, Odame I, Atrash HK, Amenda DD, Piel FB, Williams TN. Sickle cell disease in Africa. A Neglected Cause of Early Childhood Mortality. Am J Prev Med. 2011;41(6S4):S398-S3405.
Thompson J, Reid M, Hambleton I, Serjeant GR. Albuminuria and renal function in homozygous sickle cell disease: Observations from a cohort study. Arch Intern Med. 2007;167(7):701–708.
Asinobi AO, Fatunde OJ, Brown BJ, Osinusi K, Fasina NA. Urinary tract infection in febrile children with sickle cell anaemia in Ibadan, Nigeria. Ann Trop Paediatr. 2003;23:129-134.
Diallo D, Tchernia G. Sickle cell disease in Africa. Current Opinion in Hematology. 2002;9(2):111–116.
Piel FB, Patil AP, Howes RE. Global epidemiology of Sickle haemoglobin in neonates: A contemporary geostatistical model-based map and population estimates. The Lancet. 2013;381(9861): 142–151.
Ataga KI, Orringer EP. Renal abnormalities in sickle cell disease. Am J Hematol. 2000;63(4):205-211.
Ohene-Frempong K, Oduro J, Tetteh H, Nkrumah F. Screening newborns for sickel cell disease in Ghana. Pediatics. 2008;121:S120-S121.
Konotey-Ahulu FID. Sickle cell disease patient. Tetteh A'Domeno Company. 1996; 376377.
Ajasin MA, Adegbola RA. Asymptomatic bacteriuria in children with sickle cell anaemia. Nig J Paediatr. 1988;15:19-25.
Akinbami AA, Ajibola S, Bode-Shojobi I, Oshinaike O, Adediran A, Ojelabi O, Osikomaiya B, Ismail K, Uche E, Moronke R. Prevalence of significant bacteriuria among symptomatic and asymptomatic homozygous sickle cell disease patients in a tertiary hospital in Lagos, Nigeria. Niger J Clin Pract. 2014;17:163-167.
Chukwu FB, Okafor UH, Ikefuna NA. Asymptomatic bacteriuria in chilfren with sickle cell anemia at the University of Nigeria teaching hospital, Enugu, South East, Nigeria. Italian Journal of Paediatrics. 2011;37(45):1-5.
Tarry WF, Dukket JW, Synder Mc. Urological complications of sickle cell disease in a padiatric population. J Urol. 1987;138:592-594.
Brown BJ, Asinobi AO, Fatunde OJ, Osinusi K, Fasina NA. Antimicrobial sensitivity patterns of organisms causing urinary tract infections in children with sickle anemia in Ibadan, Nigeria. West Afr J Med. 2003;22:110-113.
Farrell DJ, Morrissey I, De Rubeis D, et al. A UK multicentre study of antimicrobial susceptibility of bacterial pathogens causing UTI. J Infect. 2003;46(2):94-100.
Okafor HU, Okoro BA, Ibe BC, Njoku Obi NU. Bacteriology of asymptomatic bacteriuria in preschool children in Enugu. Orient J Med. 2005;17:37-42.
Cumming V, Ali S, Forrrester T, Roye-Green K, Reid M. Asymptomatic bacteriuria in sickle cell disease: A cross-sectional study. BMC Infectious Diseases. 2006;6:46.
Iwalokun BA, Iwalokun SO, Hodonu SO, Aina OA, Agomo PU. Evaluation of micro albuminuria in relation to asymptomatic bacteruria in Nigerian patients with sickle cell anemia. Saudi J Kidney Dis Transpl. 2012;23:1320-1330.
Inyang-Etoh PC, Udofia GC, Alaribe AA, Udonwa NE. Asymptomatic bacteriuria in patients on antiretroviral drug therapy in Calabar. J Med Sci. 2009;9:270-275.
Kayima JK, Otieno LS, Twahir A, Njenga E. Asymptomatic bacteriuria among diabetics attending Kenyatta National Hospital. East Afr Med J. 1996;73:524- 526.
Kumamoto Y, Tsukamoto T, Matsukawa M, Kunishima Y, Hirose T, Yamaguti O. Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2002). I. Susceptibility distribution. Jpn J Antibiot. 2004;57:246-274.