ISOLATION AND CHARACTERIZATION OF UROPATHOGENIC ESCHERICHIA COLI IN WATER CLOSET USED BY MALE STUDENTS IN A TERTIARY INSTITUTION IN NIGERIA

CHAPTER ONE

INTRODUCTION

Background of the study: Urinary tract infections (UTIs) are primarily caused by the presence and multiplication of microorganisms in the urinary tract (McDaniel and Kaper, 1997). Escherichia coli is the causative pathogen in 70–95% of acute, uncomplicated UTIs in adults, followed by other Enterobacteriaceae, like Proteus mirabilis and Klebsiella spp., and by Staphylococcus saprophyticus in 5–10% of cases (Garbe et al., 2015). The onset of UTIs is primarily caused by the ascent of microorganisms from the urethra. When the pathogen can penetrate the urinary tract system and accumulates to more than 105 colonies/ml in urine, a urinary tract infection (UTI) result (Smelov et al., 2010). One to three percent of consultations is for urinary tract infections (UTI), the most frequent bacterial illness seen in general practice (Goddard et al., 2010). About 150 million individuals worldwide are diagnosed with (UTI) each year, and it affects all age groups, from neonates to the elderly. Financially, community-acquired UTI’s expensive, costing the world economy more than six billion US dollars. Lower UTI is defined as the involvement of the urethra, bladder, prostate, epididymis, and testis (Das and Banerjee, 2015). Upper UTI is the term for the condition that affects the kidneys and ureters. Bacteria most frequently enter the urinary system by the ascending transurethral pathway, but they can also enter through the bloodstream or lymphatics (Yagoob, 2009). Every year, 150 million humans around the world are affected with UTIs, one of the most frequent bacterial diseases (Harding and Ronald, 2016). Although both men and women can get infected, UTIs are typically thought of as a condition that only affects women, who have a 50% lifetime prevalence (Foxman, 2014). Because multidrug-resistant Uropathogens are more common and antibiotic treatment for acute infections does not prevent recurrences, current treatments are not optimum (Gupta K et al., 2001; Al-Badr and Al-Shaikh, 2013). The majority of UTIs are caused by Uropathogenic Escherichia coli (UPEC) strains, which have a variety of virulence characteristics for their pathogenicity in the urinary system, including fimbriae, capsules, iron scavenger receptors, flagella, toxins, and lipopolysaccharide. Due to differences in anatomical structure and the greater risk of infection following bladder catheterization, which weakens natural defence mechanisms, women have UTIs more frequently than males. Only a small percentage of UTIs are hematogenous in origin, and these infections are typically brought on by a few relatively rare bacteria (such as Staphylococcus aureus, Candida spp., and Mycobacterium tuberculosis), which cause primary infections elsewhere in the body and then spread to the urinary tract (Wittenberg et al., 2014). Both sexes are susceptible to urinary tract infections. However, women are more likely to experience it, particularly when they are sexually active for reproduction. This is brought on by their narrow urethra, injuries sustained during sexual activity, and lack of bactericidal secretions (Ronald, 2003). If the lower urinary tract is affected, urinary tract infection (UTI) symptoms such as dysuria, frequency, urgency, strangulation, and suprapubic pain may also be present (Biswas et al, 2010). Fever, sensitive and painful loins are the symptoms of an upper (UTI). Asymptomatic urinary tract infections may be found during routine examinations (Goddard et al., 2010). When looking at the urine under a microscope for a UTI, pus cells (white blood cells, WBCs, or red blood cells) may be visible (RBCs). Pyuria is defined as having six to ten or more pus cells per High Power Field (HPF) of freshly voided midstream urine that are unspun (Mangula et al., 2013). When there are two or more leucocytes in the urine, it is considered to be significant pyuria (Anígilájé and Bitto). One of the most frequent locations for bacterial infections is the urinary system, where E. coli is by far the most prevalent pathogen. The strains of commensal E. coli that make up the majority of the E. coli infecting the lower colon of people are different from the subgroup of E. coli that causes simple cystitis and acute pyelonephritis. Six O serogroups account for 75% of UTIs caused by E. coli, and these six groups feature characteristics that are epidemiologically linked to acute pyelonephritis and cystitis in the normal urinary tract, including expression of P fimbriae, haemolysin, aerobactin, serum resistance, and encapsulation (Turner et al., 2006).

1.2 STATEMENT OF PROBLEM

Studies on Urinary Tract Infections (UTIs) associated with Pathogenic bacterium have revealed that Uropathogenic E. coli continues to be the primary cause of UTIs and is also the cause of multifactorial nosocomial infections (Bigwan and David, 2013). According to estimates, E. coli causes 80% of all uncomplicated UTIs and 18–35% of UTIs linked with long-term indwelling catheters. From numerous studies on the Uropathogens obtained from inpatients and outpatients revealed that UPEC isolates were the most prevalent isolate in UTI patients (Salvador et al., 2012). This study's objectives include determining the prevalence of E. coli species that have not yet been examined, evaluating and validating the claims made about the species, and determining the percentage of a particular population that is impacted by Uropathogenic E. coli species (Muller et al., 2009).