Outcome of Urine cultures at the medical Microbiology laboratory of Makerere University college of Health Sciences
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Background: Urinary tract infections(UTIs) are infections involving the kidneys, ureters, bladder and urethra. They are among the most common infections in the world. UTIs have become the most common hospital-acquired infection, accounting for as many as 35% of nosocomial infections, and they are the second most common cause of bacteremia in hospitalized patients. Though many tests can be performed to detect them, urine culture remains the the gold standard of UTI diagnosis and may have different outcomes. The aim of this study was to therefore assess the prevalence of different outcomes of urine cultures in Makerere university microbiology laboratory. Objectives: The main objective was to assess the prevalence of different urine culture outcomes in Makerere University microbiology laboratory. Methodology: A cross sectional study was carried out in Makerere university medical microbiology laboratory. The study involved a one month prospective and two months retrospective data on urine culture samples. Information urine culture samples was collected using a precoded and pretested questionnaire. Data was collected on socio-demographics of patient from whom urine sample was obtained, hospital of urine collection, urine collection method, dates and times of; sample collection, reception, innoculation and report dates. Data was also collected on outcome of urine cultures and the species of pathogen isolated if present. Collected data was exported to EpiData software and analysed using both EpiData analysis and Microsoft Excel. Turnover time averages were obtained and relations between the relative proportions of urine culture outcomes and their affecting factors established. Results: Of the 74 samples studied, 35(47.3%) samples were from males, 34(45.9%) samples were from females with 5(6.8%) of samples having missing sex. Majority of samples belonged to patients aged between 30 and 39 years. The prevalence of the outcomes was as follows: 30(40.5%) samples exhibited no growth at all, 18(24.3%) samples exhibited growth of one pathogen ≥105 CFU/mL, 1 (1.4%) samples exhibited growth of one pathogen 103 ≤ 104 CFU/mL, 2(2.7%) samples exhibited growth of one pathogen ≤ 102 CFU/mL, 12 (16.2%) samples exhibited mixed floral growth, 8(10.8%) samples exhibited other growth types with 3(4.1%) of samples missing results. Echerichia coli was the commonest pathogen isolated from positive urine cultures. Overall average turn around time of the urine culture process was 1.33 days. Of all the influencing factors studied, patient sex and age were found to possibly influence the urine culture outcome. Other factors like urine collection method and ward of collection could not be studied because of the great number of missing data in these fields. Conclusions: The high prevalence of mixed floral growth is unacceptable and may be due to poor collection and transport techniques. There is a laxity among health workers in providing enough information in laboratory request forms accompanying urine cultures. Escherichia coli is the most common pathogen isolated in positive urine cultures.