Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania: a laboratory based cross- sectional study

Betrand Msemwa; Martha F. Mushi; Benson Kidenya; Bernard Okamo; Katherine Keenan; Wilber Sabiiti; Donald N. Miyaye; Eveline T. Konje; Vitus Silago; Mariam M. Mirambo; Joseph R. Mwanga; Stephen Gillespie; Antonio Maldonado-Barragan; Alison Sandeman; Mathew Holden; Stephen E. Mshana

doi:10.1016/j.ijregi.2022.12.007

Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania: a laboratory based cross- sectional study

Betrand Msemwa, Martha F. Mushi^*, Benson Kidenya, Bernard Okamo, Katherine Keenan, Wilber Sabiiti, Donald N. Miyaye, Eveline T. Konje, Vitus Silago, Mariam M. Mirambo, Joseph R. Mwanga, Stephen Gillespie, Antonio Maldonado-Barragan, Alison Sandeman, Mathew Holden, Stephen E. Mshana

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background
Urogenital pathogens such as Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis have been reported to cause pyuria, however they are not routinely cultured from urine samples of patients clinically diagnosed to have urinary tract infections (UTI). In this study, pathogen specific PCR was done to identify the urogenital pathogens in the urine samples among clinically diagnosed UTI patients with negative routine urine culture.

Methods
A cross-sectional study was conducted involving 227 archived urine samples from clinically diagnosed UTI patients with positive leucocyte esterase but negative urine culture results. The urogenital pathogens were detected using pathogen specific singleplex PCR. Data were cleaned and analyzed using STATA version 15.

Results
The median age of patients was 31[IQR 23 – 51] years and the majority (174, 76.7%) were females. Two thirds of patients had history of antibiotic use two weeks prior to recruitment (154, 67.8%). A total of 62(27.3%) urine samples were positive for at least one urogenital pathogen. Of 62 positive samples, 9 had two urogenital pathogens and 1 had three urogenital pathogens. The most predominant urogenital pathogen detected was Neisseria gonorrhoeae 25(34.2%) and Trichomonas vaginalis 24(32.9%). Being female (aOR 2.4; 95% CI: 1.04 – 5.49; p-value 0.039) and having history of using antibiotics in the past two weeks (aOR 1.9; 95%CI: 1.04 – 3.60; p-value 0.036) was independently associated with the presence of urogenital pathogens.

Conclusion
More than a quarter of female patients with clinical symptoms of UTI and routine urine culture negative results were infected with urogenital pathogens mainly Neisseria gonorrhoeae and Trichomonas vaginalis. Further research with a larger sample set in a range of settings is required to understand the implications of these finding generally.

Original language	English
Pages (from-to)	170-175
Number of pages	6
Journal	IJID Regions
Volume	7
Early online date	7 Apr 2023
DOIs	https://doi.org/10.1016/j.ijregi.2022.12.007
Publication status	Published - 1 Jun 2023

Keywords

Sexual transmitted infection
Pyuria
UTI culture negative
Leukocyte esterase

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10.1016/j.ijregi.2022.12.007Licence: CC BY-NC-ND

Msemwa_2023_IJID_R_Urogenital-pathogens_CC
Crown Copyright © 2023 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Final published version, 847 KBLicence: CC BY-NC-ND

Kesby/Keenan HATUA: Holistic Approach to Unravel Antibacterial resistance in East Africa (HATUA)
Kesby, M. (PI) & Keenan, K. L. (CoI)
Medical Research Council
1/05/18 → 31/03/22
Project: Standard

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Msemwa, B., Mushi, M. F., Kidenya, B., Okamo, B., Keenan, K., Sabiiti, W., Miyaye, D. N., Konje, E. T., Silago, V., Mirambo, M. M., Mwanga, J. R., Gillespie, S., Maldonado-Barragan, A., Sandeman, A., Holden, M., & Mshana, S. E. (2023). Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania: a laboratory based cross- sectional study. IJID Regions, 7, 170-175. https://doi.org/10.1016/j.ijregi.2022.12.007

@article{23c7476963c94912986986795cae0508,

title = "Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania: a laboratory based cross- sectional study",

abstract = "Background Urogenital pathogens such as Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis have been reported to cause pyuria, however they are not routinely cultured from urine samples of patients clinically diagnosed to have urinary tract infections (UTI). In this study, pathogen specific PCR was done to identify the urogenital pathogens in the urine samples among clinically diagnosed UTI patients with negative routine urine culture. MethodsA cross-sectional study was conducted involving 227 archived urine samples from clinically diagnosed UTI patients with positive leucocyte esterase but negative urine culture results. The urogenital pathogens were detected using pathogen specific singleplex PCR. Data were cleaned and analyzed using STATA version 15. Results The median age of patients was 31[IQR 23 – 51] years and the majority (174, 76.7%) were females. Two thirds of patients had history of antibiotic use two weeks prior to recruitment (154, 67.8%). A total of 62(27.3%) urine samples were positive for at least one urogenital pathogen. Of 62 positive samples, 9 had two urogenital pathogens and 1 had three urogenital pathogens. The most predominant urogenital pathogen detected was Neisseria gonorrhoeae 25(34.2%) and Trichomonas vaginalis 24(32.9%). Being female (aOR 2.4; 95% CI: 1.04 – 5.49; p-value 0.039) and having history of using antibiotics in the past two weeks (aOR 1.9; 95%CI: 1.04 – 3.60; p-value 0.036) was independently associated with the presence of urogenital pathogens. ConclusionMore than a quarter of female patients with clinical symptoms of UTI and routine urine culture negative results were infected with urogenital pathogens mainly Neisseria gonorrhoeae and Trichomonas vaginalis. Further research with a larger sample set in a range of settings is required to understand the implications of these finding generally.",

keywords = "Sexual transmitted infection, Pyuria, UTI culture negative, Leukocyte esterase",

author = "Betrand Msemwa and Mushi, {Martha F.} and Benson Kidenya and Bernard Okamo and Katherine Keenan and Wilber Sabiiti and Miyaye, {Donald N.} and Konje, {Eveline T.} and Vitus Silago and Mirambo, {Mariam M.} and Mwanga, {Joseph R.} and Stephen Gillespie and Antonio Maldonado-Barragan and Alison Sandeman and Mathew Holden and Mshana, {Stephen E.}",

note = "Funding: This study is part of the Holistic Approach to Unravel Antibacterial Resistance in East Africa (HATUA) project funded by the National Institute for Health Research, Medical Research Council and the Department of Health and Social Care, Award (MR/S004785/1).",

year = "2023",

month = jun,

day = "1",

doi = "10.1016/j.ijregi.2022.12.007",

language = "English",

volume = "7",

pages = "170--175",

journal = "IJID Regions",

issn = "2772-7076",

publisher = "Elsevier",

}

Msemwa, B, Mushi, MF, Kidenya, B, Okamo, B, Keenan, K , Sabiiti, W, Miyaye, DN, Konje, ET, Silago, V, Mirambo, MM, Mwanga, JR, Gillespie, S, Maldonado-Barragan, A, Sandeman, A , Holden, M & Mshana, SE 2023, 'Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania: a laboratory based cross- sectional study', IJID Regions, vol. 7, pp. 170-175. https://doi.org/10.1016/j.ijregi.2022.12.007

TY - JOUR

T1 - Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania

T2 - a laboratory based cross- sectional study

AU - Msemwa, Betrand

AU - Mushi, Martha F.

AU - Kidenya, Benson

AU - Okamo, Bernard

AU - Keenan, Katherine

AU - Sabiiti, Wilber

AU - Miyaye, Donald N.

AU - Konje, Eveline T.

AU - Silago, Vitus

AU - Mirambo, Mariam M.

AU - Mwanga, Joseph R.

AU - Gillespie, Stephen

AU - Maldonado-Barragan, Antonio

AU - Sandeman, Alison

AU - Holden, Mathew

AU - Mshana, Stephen E.

N1 - Funding: This study is part of the Holistic Approach to Unravel Antibacterial Resistance in East Africa (HATUA) project funded by the National Institute for Health Research, Medical Research Council and the Department of Health and Social Care, Award (MR/S004785/1).

PY - 2023/6/1

Y1 - 2023/6/1

N2 - Background Urogenital pathogens such as Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis have been reported to cause pyuria, however they are not routinely cultured from urine samples of patients clinically diagnosed to have urinary tract infections (UTI). In this study, pathogen specific PCR was done to identify the urogenital pathogens in the urine samples among clinically diagnosed UTI patients with negative routine urine culture. MethodsA cross-sectional study was conducted involving 227 archived urine samples from clinically diagnosed UTI patients with positive leucocyte esterase but negative urine culture results. The urogenital pathogens were detected using pathogen specific singleplex PCR. Data were cleaned and analyzed using STATA version 15. Results The median age of patients was 31[IQR 23 – 51] years and the majority (174, 76.7%) were females. Two thirds of patients had history of antibiotic use two weeks prior to recruitment (154, 67.8%). A total of 62(27.3%) urine samples were positive for at least one urogenital pathogen. Of 62 positive samples, 9 had two urogenital pathogens and 1 had three urogenital pathogens. The most predominant urogenital pathogen detected was Neisseria gonorrhoeae 25(34.2%) and Trichomonas vaginalis 24(32.9%). Being female (aOR 2.4; 95% CI: 1.04 – 5.49; p-value 0.039) and having history of using antibiotics in the past two weeks (aOR 1.9; 95%CI: 1.04 – 3.60; p-value 0.036) was independently associated with the presence of urogenital pathogens. ConclusionMore than a quarter of female patients with clinical symptoms of UTI and routine urine culture negative results were infected with urogenital pathogens mainly Neisseria gonorrhoeae and Trichomonas vaginalis. Further research with a larger sample set in a range of settings is required to understand the implications of these finding generally.

AB - Background Urogenital pathogens such as Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis have been reported to cause pyuria, however they are not routinely cultured from urine samples of patients clinically diagnosed to have urinary tract infections (UTI). In this study, pathogen specific PCR was done to identify the urogenital pathogens in the urine samples among clinically diagnosed UTI patients with negative routine urine culture. MethodsA cross-sectional study was conducted involving 227 archived urine samples from clinically diagnosed UTI patients with positive leucocyte esterase but negative urine culture results. The urogenital pathogens were detected using pathogen specific singleplex PCR. Data were cleaned and analyzed using STATA version 15. Results The median age of patients was 31[IQR 23 – 51] years and the majority (174, 76.7%) were females. Two thirds of patients had history of antibiotic use two weeks prior to recruitment (154, 67.8%). A total of 62(27.3%) urine samples were positive for at least one urogenital pathogen. Of 62 positive samples, 9 had two urogenital pathogens and 1 had three urogenital pathogens. The most predominant urogenital pathogen detected was Neisseria gonorrhoeae 25(34.2%) and Trichomonas vaginalis 24(32.9%). Being female (aOR 2.4; 95% CI: 1.04 – 5.49; p-value 0.039) and having history of using antibiotics in the past two weeks (aOR 1.9; 95%CI: 1.04 – 3.60; p-value 0.036) was independently associated with the presence of urogenital pathogens. ConclusionMore than a quarter of female patients with clinical symptoms of UTI and routine urine culture negative results were infected with urogenital pathogens mainly Neisseria gonorrhoeae and Trichomonas vaginalis. Further research with a larger sample set in a range of settings is required to understand the implications of these finding generally.

KW - Sexual transmitted infection

KW - Pyuria

KW - UTI culture negative

KW - Leukocyte esterase

U2 - 10.1016/j.ijregi.2022.12.007

DO - 10.1016/j.ijregi.2022.12.007

M3 - Article

SN - 2772-7076

VL - 7

SP - 170

EP - 175

JO - IJID Regions

JF - IJID Regions

ER -

Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania: a laboratory based cross- sectional study

Abstract

Keywords

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Kesby/Keenan HATUA: Holistic Approach to Unravel Antibacterial resistance in East Africa (HATUA)

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