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. 2022 Dec 27:7:170-175.
doi: 10.1016/j.ijregi.2022.12.007. eCollection 2023 Jun.

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

Betrand Msemwa  1 , Martha F Mushi  2 , Benson Kidenya  3 , Bernard Okamo  3 , Katherine Keenan  4 , Wilber Sabiiti  5 , Donald N Miyaye  6 , Eveline T Konje  7 , Vitus Silago  2 , Mariam M Mirambo  2 , Joseph R Mwanga  8 , Stephen Gillespie  5 , Antonio Maldonado-Barragan  5 , Alison Sandeman  5 , Mathew Holden  5 , Stephen E Mshana  2
Affiliations

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

Betrand Msemwa et al. IJID Reg. .

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.

Keywords: Pyuria; Sexual transmitted infection; UTI culture negative; leukocyte esterase.

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Figures

Figure 1:
Fig. 1
Flow chart diagram for sample retrieval and processing.
Figure 2:
Fig. 2
Representative Images for PCR products electrophoresed on a 1.2% (wt/vol) agarose gel, stained with red safe and photographed under UV light: M=Marker 100bp, P-positive control, N- Negative control, lane number 1,3,4,5,6,8 and 9 are positive for T. vaginalis with 89bp.
Figure 3
Fig. 3
Pattern of the detected urogenital pathogens.
See this image and copyright information in PMC

References

    1. Goonewardene S, Persad R. Sterile pyuria: a forgotten entity. Ther Adv Urol. 2015;7:295–298. doi: 10.1177/1756287215592570. - DOI - PMC - PubMed
    1. Wise GJ, Schlegel PN. Sterile pyuria. N Engl J Med. 2015;372:1048–1054. doi: 10.1056/NEJMra1410052. - DOI - PubMed
    1. Olaru ID, Chisenga M, Yeung S, Mabey D, Marks M, Chonzi P, et al. Sexually transmitted infections and prior antibiotic use as important causes for negative urine cultures among adults presenting with urinary tract infection symptoms to primary care clinics in Zimbabwe: a cross-sectional study. BMJ Open. 2021;11 doi: 10.1136/bmjopen-2021-050407. - DOI - PMC - PubMed
    1. Nassar FA, Abu-Elamreen FH, Shubair ME, Sharif FA. Detection of Chlamydia trachomatis and Mycoplasma hominis, genitalium and Ureaplasma urealyticum by polymerase chain reaction in patients with sterile pyuria. Adv Med Sci. 2008;53:80–86. doi: 10.2478/v10039-008-0020-1. - DOI - PubMed
    1. Grad AI, Vica ML, Matei HV, Grad DL, Coman I, Tataru DA. Polymerase chain reaction as a diagnostic tool for six sexually transmitted infections - preliminary results. Clujul Med. 2015;88:33–37. doi: 10.15386/cjmed-373. - DOI - PMC - PubMed

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