ANTIBIOGRAM OF PATHOGENIC BACTERIA ISOLATED FROM PRE- AND POST-SURGERY VESICOVAGINAL FISTULA (VVF) PATIENTS IN ABAKALIKI, EBONYI STATE

Vesicovaginal fistula (VVF) is an abnormal fistulous tract that extends between the bladder and the vagina – thus allowing the continuous involuntary discharge of urine into the vaginal vault of the affected patient. This study evaluated presumptively the prevalence and antibiogram of pathogenic bacteria isolated from pre- and post-surgery VVF patients. Urine samples were collected in duplicates from the VVF patients; and these were bacteriologically analyzed using cysteine lactose electrolyte deficient (CLED) agar, MacConkey agar and blood agar. Susceptibility studies were carried out on the isolated pathogens using the disk diffusion method. Klebsiella pneumoniae, Escherichia coli, S. pyogenes and S. aureus were the most isolated bacteria from the urine samples of pre- and post-surgery VVF patients. The organisms showed highest levels of resistance to ceftazidime, cotrimoxazole, amoxicillin, nitrofurantoin, cefuroxime, amoxicillin-clavulanic acid and tetracycline. With the exception of some S. aureus isolates, all the organisms including K. pneumoniae, E. coli and S. aureus were completely resistant to imipenem. However, gentamicin, ciprofloxacin, and ofloxacin showed appreciable levels of antimicrobial efficacy against the E. coli, K. pneumoniae, S. pyogenes and S. aureus isolates from both the pre- and post-surgery VVF patients. The complications of UTI in VVF patients necessitate the need to back up treatment with proper susceptibility studies. Our study has shown that the isolated organisms are resistant to some commonly used drugs. Thus it is vital to make antimicrobial stewardship a vital part of VVF management in our hospitals so that antibiotic therapy for such affected patients can be properly guided