Microbiological Profile of Urinary Tract Infections in Males: A Cross-sectional Study

Introduction: Urinary Tract Infections (UTIs) are uncommon among men. It is because the male urethra is longer and is away from the anal opening. Moreover, the perianal area is dry, and the prostatic secretion prevents from occurring of any infection. Hence, if men suffer from UTI, it is considered as a complicated infection. Complicated UTIs are difficult to treat and are more prone to treatment failures. Microorganisms causing these infections have a wide spectrum ranging from a variety of both Gram-negative and Gram-positive organisms. Early diagnosis and treatment of UTIs, plays a major role in preventing the spread of infection to the upper urinary tract.

Aim: To determine the microbiological profile and antibiotic sensitivity pattern from urine samples of male patients.

Materials and Methods: The present cross-sectional study was done for a period of two years (1/3/2019 to 31/4/2021) in the Department of Microbiology, Malla Reddy Institute of Medical Sciences and Research, Jeedimetla, Hyderabad, Telangana, India. Urine samples from male inpatients and outpatients suffering from various clinical conditions received in the microbiology laboratory were processed and analysed. These samples were cultured by conventional semiquantitative methods and the organisms were identified using standard biochemical reactions. Antibiotic sensitivity testing was done on Mueller Hinton agar by Kirby-Bauer’s disk diffusion technique. Clinical history, associated conditions and co-morbidities were noted from the case sheets of all the culture positive patients to identify the risk factors which made them prone to UTIs. The data was descriptive and percentages were calculated for all the numerical data obtained.

Results: Total 304 urine samples received, 104 (34%) were found to be positive for bacterial and fungal isolates. E. coli (44%) was the predominant organism, followed by Klebsiella spp. (15%) among the Gram-negative bacteria isolated. Coagulase-negative Staphylococcus (5%) was the predominant organism among the Gram-positive bacteria followed by Staphylococcus aureus (4%) and Enterococcus spp. (4%). A 84.8% of E. coli and 68% of Klebsiella spp. were Extended-spectrum beta-Lactamase (ESBL) enzymes producing organisms. An analysis of the health conditions of the patients who were culture positive showed that 28% of patients had signs and symptoms suggestive of UTI. Diabetes (25%), hypertension (20%), and Benign Prostatic Hyperplasia (BPH) (5%) were observed commonly in patients above 60 years.

Conclusion: The UTI in male patients are quite uncommon as in female patients. The microbiological profile and drug sensitivity pattern of these organisms causing the infection is similar to that in female patients suffering from UTI. But, as UTI in males is considered a complicated infection thorough investigation of these patients for various health conditions like diabetes mellitus, hypertension and BPH has to be done, particularly in elderly males. This helps in initiating prompt treatment to prevent recurrent UTIs and drug resistance.