Abstrakti
Background: Vesico-vaginal fistula (VVF) is a major
gynaecological problem in developing countries
especially Sub-Saharan region and presence of
pathogenic microorganisms in the urine of post
repaired VVF patients may lead to surgical failure;
and chances of successful repair decreases after first
attempt; it may also lead to Urinary tract infection
(UTI) and its complications.
Objective: This study determined the microbial
organisms present in urine samples of post repaired
vesico-vaginal fistula patients as well as their
antibiotic sensitivity pattern among patients at Laure
fistula center (LFC), Murtala Muhammad Specialist
Hospital, Kano
Methods: A Cross sectional descriptive study was
conducted among post repaired VVF patients at LFC,
Murtala Muhammad Specialist Hospital, Kano. Data
relating to the study were obtained using a structured
questionnaire. Urine samples were collected from
an indwelling urethral catheter on day 7 after surgery
and were subjected to microscopy, culture and
sensitivity, to determine the microbial organisms and
their sensitivity pattern. Data obtained were analyzed
using SPSS version 20 (SPSS Inc, Chicago, USA,
2009).
Results: The incidence of significant bacteriuria
among post repair vesico-vaginal fistula patients from
this study was 43.5%. The associated risk factors
were previous catheterization, previous fistula repair
and duration of labor for more than 24 hours, the
association between these risk factors and
development of bacteriuria was statistically significant
(p values < 0.05). The microorganisms implicated
were Pseudomonas aeruginosa, Proteus mirabilis,
Escherichia coli and Klebsiella pneumoniae. These
organisms showed various levels of sensitivity and
resistance to the antibiotics used. All the organisms
were highly sensitive to Ciprofloxacin, Cefuroxime,
Ceftriaxone and Gentamicin at varying degrees.
There was significant resistance to Amoxicillin and
Tetracycline; and 100% resistance to Trimetoprim/
Sulphamethoxazole.
Conclusion- The incidence of significant bacteriuria
was high after surgical repair. It is therefore clear
that vesico-vaginal fistula patients are at risk of
developing post repair significant bacteriuria. The use
of prophylactic antibiotic before or immediately after
surgery is important among these patients.
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