Prevalence of Symptomatic Bacteriuria and Associated Risk Factors among Patients Attending Major Hospitals in Calabar, Nigeria

Introduction Urinary tract infections (UTIs) are among the most encountered bacterial infection of humans and affect both male and female of all age groups, resulting in high mortality of infected patients if not properly managed. Hypothesis/Gap statement Several studies in different sub-Saharan Africa locations show variations in incidence of UTI as well as it’s causative organisms. Aim This study aimed to assess the prevalence, etiological agents, and factors associated with urinary tract infections among patients attending selected hospitals in Calabar metropolis, Nigeria. Methodology This was a cross-sectional study. Mid-stream urine samples collected from 240 patients with UTI were cultured using Cystine Lactose Electrolyte Deficient Agar (CLED). Data on socio-demographic, clinical symptoms and risk factors were obtained using structured questionnaire. Uropathogens were characterized using microbiological and biochemical tests and confirmed with API® 20E and 20NE (Biomérieux) identification system. Pearson Chi-square was employed to check associations between categorical variables. P -value of <.05 was considered statistically significant. Results Out of the 240 urine samples collected, 13 were contaminated during collection, and 227 analyzed. Sixty-five (28.6%) patients had significant bacteriuria. Previous history of UTI ( P =.000, CI=1.582-5.180), use of drugs without prescription ( P =.000, CI=0.040-0.220), pregnancy ( P =.001, CI=1.858-12.575) and history of urinary catheter ( P =.031, CI=1.024-19.053) showed significant association with the occurrence of UTI. Klebsiella pneumoniae (23.1%) was the most predominant isolate, followed by Coagulase-negative Staphylococci (16.9%) and Escherichia coli (12.3%). Conclusion The study shows that routine UTI screening is beneficial for pregnant women, patients with difficult or painful urination, patients with previous episodes of UTI, catheterized patients and appropriate drugs administered for positive cases. In addition, self-administration of antibiotics should be avoided. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement FUNDING: This study was funded by the Tertiary Educationa Trust Fund (TeTfund) under the Institution Based Research (IBR) Grant. The funder payed no role in the study design, data colection and analyss, and manuscrpt preparation. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval for this study was obtained from the Cross River State Health Research Ethics Committee (CRS-HREC) with REC No: CRSMOH/RP/2021/183. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data regenerated in this study are available upon request by the publisher or any researcher provided it is not for commercial purposes.