ANTIBIOTICS SUSCEPTIBILITY PATTERN OF SOME SELECTED BACTERIA (BATONELLA, BACILLUS, SALMONELLA) ASSOCIATED WITH URINARY TRACT INFECTION AMONG PATIENT'S ATTENDING GENERAL HOSPITAL MINNA NIGER STATE

1.1 Background of the Study

Urinary tract infections (UTIs) are a significant public health concern, affecting millions globally and imposing a considerable burden on healthcare systems, particularly in developing regions (Falguni et al., 2021). Infections in the urinary tract are primarily caused by bacteria, with species such as Escherichia coli, Klebsiella spp., and Proteus mirabilis as common culprits. However, less frequently reported bacterial strains, including Bartonella, Bacillus, and Salmonella, are increasingly implicated in UTIs, especially in patients with immunosuppression or in environments where these pathogens are prevalent (Ahmed et al., 2019). With rising rates of antimicrobial resistance (AMR), understanding bacterial susceptibility patterns is essential for effective management, as resistance rates affect treatment choices and outcomes. Recent research underscores that UTIs are especially common in healthcare settings and are often recurrent, with certain groups, such as females and elderly patients, experiencing higher incidence rates (Bushra et al., 2023). In Nigeria, where UTI cases continue to increase, this issue is compounded by the region’s high AMR prevalence, attributed to factors such as empirical prescription practices, limited diagnostic resources, and unregulated antibiotic use (Bello et al., 2020). These challenges are critical in settings like General Hospital Minna, Niger State, where patients present a variety of infections linked to bacterial strains with varied resistance patterns.

Among the causative agents of UTI, Gram-negative bacteria like Salmonella and Gram-positive bacteria such as Bacillus spp. are emerging threats due to their distinctive resistance patterns, which complicate treatment. AMR in Gram-negative bacteria, for example, is generally more prevalent and challenging to address due to mechanisms like extended-spectrum beta-lactamase (ESBL) production, which confers resistance to multiple antibiotic classes (Mathew et al., 2021). For example, Salmonella spp., a common cause of foodborne infections, has increasingly been isolated in urinary cultures, underscoring the importance of regional studies in identifying local resistance patterns (Adebola et al., 2018). Meanwhile, Bartonella, although more commonly associated with zoonotic infections, has also been identified in some urinary cases, posing a diagnostic challenge due to its atypical presentation and resistance characteristics (Njeru et al., 2022).

The use of antibiotics such as fluoroquinolones, aminoglycosides, and beta-lactams remains standard for treating UTIs. However, the effectiveness of these treatments is declining due to escalating resistance, with Bartonella showing varying levels of susceptibility across studies (Ahmed et al., 2023). Increasing AMR among UTI pathogens in Nigeria has necessitated a re-evaluation of empirical therapy protocols, especially in hospitals like General Hospital Minna, where laboratory resources are limited, and empirical treatment remains common practice (James et al., 2019). Understanding the local susceptibility patterns is vital in optimizing treatment protocols and mitigating the spread of resistant infections, reducing morbidity and healthcare costs associated with UTIs.

1.2 Statement of the Problem

The growing burden of AMR presents a critical challenge for managing UTIs, particularly in regions with limited healthcare resources and high infection rates, like Niger State, Nigeria (Akinyemi et al., 2021). The reliance on empirical antibiotic treatment in settings where laboratory confirmation of bacterial strains and susceptibility testing are often unavailable increases the risk of inappropriate treatment and AMR proliferation. In General Hospital Minna, there is a significant lack of data on the susceptibility patterns of less common bacterial strains like Bartonella, Bacillus, and Salmonella in UTIs. This gap hinders effective treatment and increases the likelihood of treatment failures, leading to prolonged infections and the potential spread of resistant bacteria in the community.

Moreover, with Salmonella and Bacillus increasingly detected in urinary cultures, the absence of a tailored approach to managing these pathogens places an additional burden on healthcare providers and patients. Failure to address these pathogens' susceptibility patterns could lead to the continued emergence of drug-resistant strains, further complicating UTI treatment. Addressing this problem by studying the local antibiotic susceptibility patterns of these bacteria is essential to guide appropriate antibiotic use, enhance patient outcomes, and prevent the community-wide spread of resistant infections (Njeru et al., 2022).

1.3 Objectives of the Study

1.3.1 General Objective

To determine the antibiotic susceptibility patterns of selected bacteria (Bartonella, Bacillus, and Salmonella) associated with urinary tract infections (UTIs) among patients attending General Hospital Minna, Niger State, Nigeria.

1.3.2 Specific Objectives

1. To identify the prevalence of Bartonella, Bacillus, and Salmonella in UTI cases among patients at General Hospital Minna.

2. To assess the antibiotic susceptibility profiles of these bacteria against commonly used antibiotics.

3. To evaluate the resistance patterns of these bacteria to determine any trends in multidrug resistance.

1.4 Research Questions

1. What is the prevalence of Bartonella, Bacillus, and Salmonella in UTI cases among patients at General Hospital Minna?

2. Which antibiotics are most effective against Bartonella, Bacillus, and Salmonella in UTI cases?

3. What patterns of antibiotic resistance are exhibited by Bartonella, Bacillus, and Salmonella in UTIs?

1.5 Significance of the Study

This study is significant because it addresses the need for current data on antibiotic susceptibility patterns of UTI-associated bacteria in Niger State, where limited resources and diagnostic facilities make empirical treatment common. The findings will help healthcare providers at General Hospital Minna make more informed decisions on antibiotic selection, potentially reducing the prevalence of inappropriate treatments and improving patient outcomes. Additionally, understanding the antibiotic resistance patterns of Bartonella, Bacillus, and Salmonella will contribute to the global effort to curb antimicrobial resistance (AMR), which is an escalating concern in developing regions (Ahmed et al., 2023; James et al., 2019).

1.6 Scope and Limitations of the Study

This study will be conducted at General Hospital Minna and will focus specifically on patients presenting with UTI symptoms. It will include only the bacterial strains Bartonella, Bacillus, and Salmonella, given their emerging association with UTIs. The study is limited by its geographical focus, meaning findings may not be generalizable to other regions of Nigeria or globally. Additionally, resource limitations may restrict access to advanced diagnostic methods, impacting the depth of antibiotic resistance profiling.

1.7 Definition of Terms

Antibiotic Susceptibility: The sensitivity or resistance of bacteria to various antibiotics, determining effective treatment options.

Urinary Tract Infection (UTI): An infection in any part of the urinary system, often caused by bacteria, leading to symptoms such as pain during urination and frequent urges to urinate.

Multidrug-Resistant (MDR): Bacteria that are resistant to multiple antibiotics, making infections harder to treat.

Empirical Treatment: Treatment based on clinical experience and general patterns of resistance, often without specific microbiological testing.