Urinary Tract infections (UTIs) are one of the most common causes of hospital visit worldwide. The study intends to find the prevalence of Escherichia coli in Urinary tract infection cases in Aminu Kano Teaching Hospital (AKTH), Kano. A comprehensive study was conducted on E coli for its prevalence in urine samples, of queried cases of urinary tract infection in patients attending Aminu Kano Teaching Hospital (AKTH), Kano. Two hundred and fourteen urine specimens comprising of 123(57.5%) females and 91(42.5%) males of all age group were screened for bacteria. Of the 214 samples, 68 representing (31.80%) were culture positive with E. coli having 32(47.06%), Klebsiella spp 18(26.47%), Staphylococcus spp 10(14.70%), Proteus spp 6(8.82%) and Pseudomonas spp 2(2.94%). Out of the 32(47.6%) of E. coli isolated, 22 were from female and 10 were from males, the highest prevalence occurred within the age range of 21-30 with females taking the lead. Antibiogram of the isolated E. coli showed a markedly good sensitivity of ofloxacin (96.87%), nitrofurantoin and nalidixic acid (93.70%), colistin phosphate (90.62%) and gentamicin (68.75%). E. coli showed the least sensitivity to ampicillin (18.75%). The frequency of E. coli obtained suggests its high prevalence. And this can be reduced using Flouroquinolones as exhibited by the susceptibility profile in this study.

1. The prevalence of Escherichia coli Causing Urinary Tract Infections in Aminu Kano Teaching Hospital, Kano, Nigeria
WJM
The prevalence of Escherichia coli Causing Urinary
Tract Infections in Aminu Kano Teaching Hospital,
Kano, Nigeria
1
*Abdulhadi Sale Kumurya and 2
Hamza Sule
1*,2
Department of Medical Laboratory Science, Faculty of Allied Health Sciences, Bayero University, Kano, Nigeria
Urinary Tract infections (UTIs) are one of the most common causes of hospital visit worldwide.
The study intends to find the prevalence of Escherichia coli in Urinary tract infection cases in
Aminu Kano Teaching Hospital (AKTH), Kano. A comprehensive study was conducted on E coli
for its prevalence in urine samples, of queried cases of urinary tract infection in patients
attending Aminu Kano Teaching Hospital (AKTH), Kano. Two hundred and fourteen urine
specimens comprising of 123(57.5%) females and 91(42.5%) males of all age group were
screened for bacteria. Of the 214 samples, 68 representing (31.80%) were culture positive with E.
coli having 32(47.06%), Klebsiella spp 18(26.47%), Staphylococcus spp 10(14.70%), Proteus spp
6(8.82%) and Pseudomonas spp 2(2.94%). Out of the 32(47.6%) of E. coli isolated, 22 were from
female and 10 were from males, the highest prevalence occurred within the age range of 21-30
with females taking the lead. Antibiogram of the isolated E. coli showed a markedly good
sensitivity of ofloxacin (96.87%), nitrofurantoin and nalidixic acid (93.70%), colistin phosphate
(90.62%) and gentamicin (68.75%). E. coli showed the least sensitivity to ampicillin (18.75%). The
frequency of E. coli obtained suggests its high prevalence. And this can be reduced using
Flouroquinolones as exhibited by the susceptibility profile in this study.
Key words: Prevalence, Urinary Tract Infection, Escherichia coli, AKTH, Kano.
INTRODUCTION
Urinary Tract Infections (UTIs) are one of the most
prevalent extra-intestinal bacterial infections. Nowadays,
it represents one of the most common diseases
encountered in medical practice affecting people of all
ages from the neonate to the geriatric age group (Kunin,
1994). Urinary tract infection is the most widespread
infectious disease after respiratory tract infection in most
communities. It is considered as a major public health
problem due to the increased costs with an estimated
150 million cases per annum worldwide (Arjunan et al.,
2010). Uropathogens responsible for UTI includes both
gram positive and gram negative bacteria. Among the
gram negative bacteria E. coli causes approximately
75% of UTIs worldwide (Beyene and Tsegaye 2011). E.
coli are one of the most important causes of community-
acquired and nosocomial infections. This organism is
therefore of clinical importance and can also be isolated
from various clinical specimens including urine (Umolu et
al., 2006), Gram-negative enteric bacilli, especially E. coli
and Klebsiella spp., are the leading pathogens, though
Enterococcus spp., yeasts, and Staphylococcus spp.
have recently emerged as prominent agents Haller et al.,
2004).
*Correspondence: Dr. Abdulhadi Sale Kumurya,
Department of Medical Laboratory Science, Faculty of
Allied Health Sciences, Bayero University, P.M.B. 3011,
Kano-Nigeria. Email: askumurya.med@buk.edu.ng, Tel.:
+2347032153561
World Journal of Microbiology
Vol. 2(2), pp. 033-037, June, 2016. © www.premierpublishers.org, ISSN: 2141-5032x
Research Article

2. The prevalence of Escherichia coli Causing Urinary Tract Infections in Aminu Kano Teaching Hospital, Kano, Nigeria
Kumurya and Sule 033
Table 1. Distribution of Urinary Tract infection in relation to sex
Table 2. Prevalence of organisms isolated from the urine samples
Organisms isolated Number of isolates Percentage (%)
Escherichia coli 32 47.6
Klebsiella spp 18 26.47
Staphylococcus spp 10 14.70
Proteus spp 6 8.82
Pseudomonas spp 2 2.94
Total 68 100
The predominance of Gram-negative species, usually
Enterobacteriaceae and, particularly, E. coli, remained
the principal pathogens causing UTI, accounting for 75 –
90 % of all urinary tract infections in both inpatients and
outpatients (Dromigny et al., 2005). Urinary tract
infections (UTIs) are a major cause of morbidity
worldwide. In a study done in Turkey on outpatient
infections, UTIs were the second most common
diagnosis after upper respiratory tract infection Avci et al.,
2006.
MATERIALS AND METHODS
Study Population
The study was conducted on specimens of patients
attending Aminu Kano Teaching Hospital, (AKTH), Kano,
Northwestern Nigeria. The Hospital serves as referral
centre for many other Hospitals within and outside the
state.
Specimen Collection and Processing
The enrolled patients, 214 in number, were educated on
how to produce clean catch mid stream urine (MSU) in
sterile universal bottles. After macroscopy, the urine
samples were immediately plated onto blood and
cysteine lactose electrolyte deficient (CLED) agar plates
using a standard wire loop (4mm in diameter) to enable
an appropriate viable count to be made after 18 – 24
hours incubation at 37
o
C. Colonies counts greater than
10
5
per ml are suggestive of significant bacteria (a true
urinary tract infection) and biochemical tests were done
to identify E. coli. Microscopic examination of the
centrifuged urine deposits, were made using x10 and x40
objectives as described by Mackey and McCartney,
(1996). Presence of 5 or more pus cells was considered
as pyuria, presence of red blood cell was also considered
as haematuria, which could be due to urinary
schistosomiasis in which case ova are likely to be seen.
The presence of calcium oxalate, yeast cells, uric acids,
casts, crystals, epithelial cell, etc. were also noted.
Samples with more than 5 pus cells were gram stained
after the microscopic examination E. coli where
suspected when Gram negative bacilli were seen (Jawetz
et al., 2000). A count of 10
5
was regarded as significant
bacteriuria Stokes and Guttman (1975), but a count less
than 10
4
was rendered insignificant due to contamination
or that urine is cultured after antimicrobial treatment has
started.
Antimicrobial Susceptibility Testing
The antibiotic profile of the isolates was determined
modified Kirby-bauer disc diffusion method (Kirby et al
1966).The plates were incubated aerobically at 37
o
C for
24 hours and zones of inhibition read. The antimicrobials
used in the study were: ofloxacin, nalidixic acid,
nitrofurantoin, ampicillin, cotrimoxazole, gentamicin,
colistin phosphate, streptomycin, and tetracycline.
Statistical Analysis
The data obtained was analyzed using Statistical
package for the social sciences (SPSS version 20).
RESULTS
Two hundred and fourteen (214) subjects were involved
in this study between which comprised of 123(57.5%)
females and 91(42.5%) males. A total of 68(31.8%)
yielded significant growth out of which 42 and 81 were
positive and negative for cultures in the females
categories and 26 and 65 were positive and negative for
cultures in males categories respectively (Table 1). Five
different uropathogens were isolated with E. coli as the
predominant 32(47/6%), Klebsiella spp 18(26.47%).
Others were Staphylococcus spp 10(14.7%) Proteus spp
6(8.82%) and Pseudomonas spp 2(2.94%) (Table 2).
Subjects Females Males
Positive infections 42(34.1%) 26(28.6%)
Negative infections 81(65.9%) 65(71.4%)
Total 123(100) 91(100)

3. The prevalence of Escherichia coli Causing Urinary Tract Infections in Aminu Kano Teaching Hospital, Kano, Nigeria
World J. Microbiol. 034
Table 3. Occurrence of Escherichia coli in UTI in relation to age and sex of the patients
Age group (yrs) Sex
Male (%)
Female (%)
Total number (%)
0 -10 1 (25.00) 3 (75.00) 4 (12.5)
11 – 20 1 (33.33) 2 (66.66) 3 (9.37)
21 – 30 4 (33.33) 8 (66.66) 12 (37.5)
31 – 40 3 (37.5) 5 (62.5) 8 (25.0)
41 – 50 1 (50.0) 1 (50.00) 2 (6.25)
51 – 60 0 (0.00) 2 (100) 2 (6.25)
61 – 70 0 (0.00) 1 (100) 1 (3.12)
Total 10 (31.3) 22 (68.7) 32 (100)
Table 4. Antimicrobial susceptibility pattern of the 32 E. coli isolates.
Antibiotics No. susceptible Percentage (%)
Ofloxacin 31 96.87
Nitrofurantoin 30 93.70
Nalidixic acid 30 93,70
Colistin phosphate 29 90.62
Gentamicin 22 68.75
Streptomycin 15 46.87
Tetracycline 9 28.12
Cotrimoxazole 7 21.87
Ampicillin 4 18.75
Table 5. Antimicrobial susceptibility pattern of the total isolates.
Isolates T/I Ofl Nit Nal Col Gen Strep Tet Cot
E.coli 32 31(96.9%) 30(93.8%) 30(93.8%) 29(90.6%) 22(68.8%) 15(46.9%) 9(28.1%) 4(12.5%)
Kleb 18 18(100.0%) 16(88.9%) 17(94.4%) 15(83.3%) 16(88.9%) 14(77.8%) 10(55.6%) 2(11.1%)
Staph 10 8(80.0%) 7(70.0%) 8(80.0%) 5(50.0%) 7(70.0%) 6(60.0%) 5(50.0%) 4(40.0%)
Prot 6 6(100.0%) 6(100.0%) 5(83.3%) 3(50.0%) 4(66.7%) 3(50.0%) 3(50.0%) 2(33.3%)
Pseud 2 2(100.0%) 1(50.0%) 2(100.0%) - 1(50.0%) 1(50.0%) - -
KEY 1: Ofl.=Ofloxacin, it. = Nitrofurantoin, Nal.= Nalidixic acid, Col.= Colistin phosphate, Gen. = Gentamycin, Strep. =
streptomycin, Tet. = Tetracyclin, Cot. = Cotromoxazole, Amp. = Ampicilin.
KEY 2 : E. coli = Eschericia coli, Kleb. = Klebsiella, Staph = Staphylococcus, Prot = Proteus, Pseud. =Pseudomonas
KEY 3: T/I Total Isolates
Distribution of E. coli according to age group revealed
highest growth on culture in the age of 21-30 while lowest
isolation rate was in 61-70 years of age respectively
{(Table 3), (figure 1)} Antibiogram on the uropathogenic
E. coli isolates suggest ofloxacin as the drug of choice
invitro by showing the highest efficacy on the isolates
than any other antimicrobial used in this study
31(96.87%) followed by nitrofurantoin, and nalidisic acid
30(93.7%) each. But cotrimoxazole and ampicilin were
relatively resisted 7(21.8%) and 4(18.75%) respectively
(Table 4 and figure 2).
DISCUSSION
Of the two hundred and fourteen (214) urine samples
used in the study, females accounted for 123(57.5%)
while males accounted for 91(42.5%). Out of these,
68(31.80%) samples yielded significant growth on
culture. This is similar to the findings in Bayelsa State,
Nigeria, Kemebradikumo et al. (2012), where 116 urine
samples were used and significant growth of 36(31.03%)
was obtained. This is however not in agreement with
study on Profile of urinary tract infection and quinolones
resistance among E. coli and Klebsiella spp isolates, by
Namratha, (2015), which had the prevalence of 62% that
almost doubles the prevalence of this study. The
representation of the uropathogens isolated revealed that
E. coli, a member of the Enterobacteriaceae, is the
principal agent of UTI in the study area 32(47.6%)
followed by Klebsiella spp18(26.47%), Staphylococcus
spp 10(14.7%), Proteus spp 6(8.82%), and
Pseudomonas spp spp 2(2.94%) as the least prevalent
uropathogen. A similar study in a tertiary hospital in

4. The prevalence of Escherichia coli Causing Urinary Tract Infections in Aminu Kano Teaching Hospital, Kano, Nigeria
Kumurya and Sule 035
Figure 1. Bar chart showing the distribution of E. coli in UTI (in relation to age and sex of the patients at AKTH)
*Absence of blue bars in the age group 51-60 and 61-70 means zero values for males at the group
Figure 2. Bar chart showing antimicrobial susceptibility pattern of the isolated E. coli from urine of patients in AKTH
Abuja, central Nigeria, Iregbu, and Nwajiobi-Princewill
(2013), proved E. coli and Klebsiella spp to be the two
predominant uropathogen 323(37%) and 202(25%)
respectively. However, P. aeruginosa, the least frequent
uropathogen in this study 2(2.94%) was the 3
rd
uropathogen 75(8.4%) ahead of Proteus spp 67(7.5%) S.
aureus 60(6.8%) and other species involved in their
study. A variant result was also observed in a study in Ile-
Ife South-Westhern Nigeria Okonko et al.,( 2009), where
S. aureus 11(28.9%) was second to E. coli 13(42.1%)
while Klebsiella spp 7(18.4%) and Pseudomonas spp
2(5.3%) followed. The same trend of E. coli leading other
uropathogen was reported by (Yabaya et al., 2012;
Mubanga et al., 2015). But, a divergent results was
obtained in a study in Kampala, (Uganda) in East Africa,
Kyabaggu et al., (2007), in which Klebsiella spp
25(21.0%) over took all other uropathogens, including E.
coli 13(10.9%). Geographical differences could be an
associated factor in this case. In relation to age, 21-30
years had the highest yield of uropathogens (37.5%).
This compares favourably with the result of
Kemebradikumo et al. (2012), which also had (53.5%) as
the highest yield in the same age bracket, against the
other age groups used. Premanatham et al. (2015) had a
slight variation in the upper range of the age group 21-40
as against 21-30 in this study and got overwhelming
growth (50.5%) compared to other age bracket in their
study. Based on this study, the most promssing drugs in
vitro were ofloxacin and nalidixic acid. This is because
the least efficacy they showed was 80% both against
Staphylococcus spp while efficacy on other species
ranged from 83.3% and 96.9% for nalidixic acid and
ofloxacin against Pseudomonas ssp and E. coli
respectively to 100% nolidixic acid and ofloxacin against

5. The prevalence of Escherichia coli Causing Urinary Tract Infections in Aminu Kano Teaching Hospital, Kano, Nigeria
World J. Microbiol. 036
Pseudomonas ssp and ,Klebsiella ssp, Preoteus ssp and
Pseudomona ssp. in that order. The least efficatious
drugs was cotrmoxazole and ampicilin with 50% and 40%
aganst Proteus ssp and Staphylococcus ssp respectively.
This is similar to the work of Ezeamaramu et al., (2015),
on Prevalence and Antimicrobial Susceptibility of Urinary
Pathogens among Pregnant Women in the Lagos
University Teaching Hospital, Lagos , Nigerial, which had
69.8% to 100% and 82.4% to 100% as lower and upper
efficacy limits for nalidixic acid and ofloxacin respectiveiy.
But they got the least effective drugs to be cotrimoxazole
and amoxicillin as against cotrimoxazole ampicillin in this
study. The cotrimoxazole had 58.8% as the highest
efficacy while amoxicillin was 100% resisted by all the
isolates invoved (incuding E coli, Klebsiella ssp, Proteus
ssp and Pseudomonas ssp) Sensitivity test on the
isolated E. coli in this study revealed ofloxacin as having
the highest efficacy in vitro (96.87%) against the
uropathogens isolated. This is in agreement with John
and Rilwanu (2013), were ofloxacin had (70.5%) as the
most effective among antimicrobials used in vitro.
CONCLUSION
It has been observed that E. coli are the principal agent
of UTI in the study area. Females and the age group of
21-30 years are the most vulnerable to the disease
according to this work and flouroquinolone group of
antibiotics are the most promising drugs against the
uropathogens isolated.
RECOMENDATION
Personal hygiene is highly advocated as the two most
frequent pathogens isolated are normal inhabitants of the
gastro intestinal tract (GIT) and adherence to therapeutic
regulations is important to avoid resistant to the
promising drugs in future.
ACKNOWLEDGEMENT
We thank the management and ethical committee of
AKTH, Kano, for the permission to conduct this work.
Contribution of all staff and colleagues of Microbiology
Department is also highly appreciated.
CONFLICTS OF INTEREST
We hereby declare that, there is no conflict of interest in
whatever form in this work.
ETHICAL ISSUES
Ethical approval was obtained from the ethical committee
of AKTH, Kano.
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Accepted 31 May, 2016.
Citation: Kumurya AS, Sule H (2016). The prevalence of
Escherichia coli Causing Urinary Tract Infections in
Aminu Kano Teaching Hospital, Kano, Nigeria. World
Journal of Microbiology, 2(2): 033-037.
Copyright: © 2016 Kumurya and Sule. This is an open-
access article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium,
provided the original author and source are cited.