Court Filings

Microbiologic Review of Seminal Fluids in a Nigerian Tertiary Health Centre

Description
Aims and Objectives: To determine the microbiologic pattern of semenal fluid in male infertility. Subjects and Methods: A retrospective laboratory review of microbiologic analysis of 360 semen samples done in Benue Results: Fifty-one percent
Categories
Published
of 5
All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
Related Documents
Share
Transcript
  Microbiologic Review of Seminal Fluids in a Nigerian Terary  Health Centre Nwadioha SI 1 , Odimayo MS 2 , Jombo GTA 1 , Nwokedi Prince EO 1 , Abba PO 1 , Agaje I 1  and Akor JO 1 1 Department of Medical Microbiology and Parasitology, College of Health Sciences, Benue State University, Makurdi, Nigeria 2 Department of Medical Microbiology and Parasitology, College of Medicine, Eki  State University, Ado Eki,  Nigeria Corresponding author: Nwadioha SI, Department of Medical Microbiology and Parasitology, College of Health Sciences, Benue State University,Makurdi, Nigeria, Tel: +234- 8056838967; E-mail: samnwa2000@yahoo.com Rec date: Jun 15, 2016; Acc date: Jul 15, 2016; Pub date: Jul 22, 2016 Copyright: © 2016 Nwadioha SI et al. This is an open-access arcle  distributed under the terms of the Creave  Commons Aribuon  License,which permits unrestricted use, distribuon,  and reproducon  in any medium, provided the srcinal author and source are credited. Citaon:  Nwadioha SI, Odimayo MS, Jombo GTA, Microbiologic Review of Seminal Fluids in a Nigerian Terary  Health Centre. Arch ClinMicrobiol. 2016, 7:4. Abstract Aims and Objecves:   To determine the microbiologic paern  of semenal uid  in male inferlity. Subjects and Methods: A retrospecve  laboratory reviewof microbiologic analysis of 360 semen samples done inBenue State University Teaching Hospital, Makurdi, fromJanuary, 2013 to January, 2016. Results:   Fiy-one  percent (N=184/360) of the semensamples was normospermic, 43% oligospermic (with 3%severe oligospermia) and 6% azoospermic. Sixty per cent(N=216/360) of the semen samples contained sperm cellsthat were mole,  30% sluggish and 10% non-mole.  Nineper cent of the semen samples contained dead sperms(necrospermic). Forty–two percent (N=150/360) of thesemen samples was infected (contained signicant number of pus cells, ≥ 2000 cells per ml). Pathogens wereisolated in 47%(N=70/150) of the infected semen samplesas follows, Staphylococcus aureus  (53%), Staphylococcus saprophytcus   (10%), Escherichia coli (11.4%), Klebsiellaspp (7.1%), Streptococcus pneumoniae (4.4%), Pseudomonas aeruginosa (7.1%) and Candida spp (7.1%). Moxioxacin  was 85% eecve,   Levooxacin  (80%), Ceazidime  (80%), Ceriaxone  (80%), Ciprooxacin  (70%), Ooxacin  (68%) and Gentamicin (60%). While Penicillin(20%) and Tetracycline (10%) showed poor acvity. Conclusion:  Regular semen microbiologic invesgaon  isquite invaluable to male inferlity   intervenon  in poorresource countries. Keywords: Male inferlity;  Microscopy; Culture; Semen introducon Introducon A semen analysis is vital tool to invesgate  male inferlity [1]. It can also be used to validate a successful vasectomy as toabsence of sperm. Fiy  per cent of couples with complaint of inferlity  havebeen associated with male factors. Inferlity,  simply is inabilityof a sexually matured couple to achieve pregnancy in presenceof regular unprotected sexual inmacy  of average of threedays in a week for a minimum of one year [2]. Infecons  of the genito-urinary tracts, hormonal imbalance,age factor, stress, environmental polluon,  some metabolicdisorders among others are contributory to male inferlity  [3].Two separate semen specimens at interval of about seven daysmay be needed to be repeated in three month me  areneeded [4].The picture of semen analysis includes as follows; thesemen is expected to liquefy within 30 minutes of ejaculaon with the volume of about 3(±2.5) ml, sperm count per ml of 20million and above; morphology which comprises theappearance, size and shape of the sperms, which must be atleast 50% normal; molity  of the sperm within one hour of  ejaculaon  must be good for at least 50% of the sperms count[5,6]. Infecon  in semen has been incriminated in 15% cases of male inferlity  in ferlity  clinics [7,8]. The infecon  can bethrough sexual transmission or urinary tract. The nidus of  infecon  is usually the prostate [9]. Inferlity  comprises 65% of gynecological consultaons  inAfrica [10]. Male inferlity  is responsible for an average of 50% inferlity  globally [10,11]. The most aected  areas lie withinthe central African region referred to as the “inferlity  belt” of Africa [11].This study therefore, was aimed at the quantave  and qualitave  values of the seminal uid  and the role of microorganisms in male inferlity. Subjects and Method Study populaon Aer  obtaining ethical clearance from the ethics commiee of Benue state university teaching hospital, we collectedsemen samples from three hundred and sixty (360) male Research Article iMedPub Journals http://www.imedpub.com/ http://dx.doi.org/10.4172/1989-8436.100056 Archives of Clinical MicrobiologyISSN 1989-8436  Vol.7 No.4:27 2016 © Copyright iMedPub | This article is available from: http://www.acmicrob.com 1  subjects. The subjects were aending  the Special TreatmentClinics/ Urology/Reproducve  clinics of Benue State UniversityTeaching Hospital from January, 2013 to January, 2016. Properhygiene was ensured in the collecon  of the samples whichwas done in one of the private rooms in the laboratory. Procedures Aer   liquefacon  of the semen; the duraon  for the liquefacon  was charted, the color noted and volume of thesemen measured. The semen was mounted on a counng chamber (Improved Neubeuer) where sperm count and sperm molity  was read according to WHO standard [1]. Cultures The following culture media plates were used; chocolate for10% carbon dioxide incubaon  and MacConkey and Blood agarfor aerobic incubaon  overnight at 37°C.The 24 hour growth was examined for size, shape, elevaon, hemolysis and other cultural characteriscs.  Gram staining wasdone and pure growth was subjected to biochemical tesng according to standard [5]. Anbiogram Anbioc   suscepbility  of the isolates was tested by agar diusion  method on dry sensivity   tesng  agar (DSTA) usingoxoid muldisc  with standard anbiocs   concentraons according to Clinical and Laboratory Standard Instute  (CLSI),2006 guidelines [12]. Analysis of data The results were analyzed using SPSS 11.0 stascalsoware;  chi-square (x 2 ) was used to compare associaon between proporons  and p-values <0.05 were considered signicant  at 95.0% condence  level. Results A total of 360 seminal uid  samples were collected. Thesperm count was as follows: Fiy-one  percent of the spermcount was normospermic, 25% mildly oligospermic, 15%moderately oligospermic, 3% severely oligospermic and 6%azoospermic (Figure 1) .Forty per cent of the sperm cells were very mole,  20% of moderate progression, 30% sluggish and 10% non-mole (Figure 2).  Viability test revealed 9% dead cells. Forty –two percent (N=150/360) of the seminal uid  samples contained signicant  number of pus cells (≥2000 cells per ml). Pathogenswere isolated in 47% (N=70/150) of this sample. The abovecriteria were distributed according to the percentage molity groups of sperm cells (Figure 3).Figure 1  The sperm count of the sample populaonaending   ferlity  clinics in Benue State University TeachingHospital from Jan, 2013- 2016. Figure 2  The percentage of subjects with their sperm molity  assessment. Figure 3  Percentage Sperm molity  in the infected Seminal uid  of some subjects aending   ferlity  clinics in BenueState University Teaching Hospital, Jan 2013-2016Total number of isolates was 70 as follows, S. aure us (53%), S. saprophytcus   (10%), E. coli   (11.4%), Klebsiella spp (7.1%), S. Archives of Clinical MicrobiologyISSN 1989-8436  Vol.7 No.4:27 2016 2 This article is available from: http://www.acmicrob.com   pneumonia (4.4%), P. aeruginosa (7.1%) and Candida spp (7.1%) (Table 1).Table 1  Microbial Isolates from semen of some subjects aending   ferlity  clinics in Benue State University Teaching Hospital,January, 2013 to January, 2016. Isolates Number Percentage (%) Staphylococcus aureus 37/7052.9 Staphylococcus saprophyticus 7/7010 Escherichia coli  8/7011.4 Klebsiella species 5/707.1 Streptococcus pneumoniae 3/704.4 Pseudomonas aeruginosa 5/707.1 Candida species 5/707.1Total Isolates7019Sterile cultures (of samples with Pus Cells ≥ 2000/ml)8022Total sterile cultures29081Total cultures360100 Moxioxacin  (85%), levooxacin  (80%), ceazidime  (80%), ceriaxone  (80%) ciprofoxacin (70%), ooxacin  (68%) andgentamicin (60%) are eecvely   acve  across the spectrum of bacteria tested. While penicillin (20%) and tetracycline (10%)are low in acvity   (Table 2). Discussion The study shows a 6% azoospermia, 43% oligospermia and51% normospermic. Some studies in Nigeria showed thefollowing results such as 8.8 % [11] azoospermia in Ogun and14.9% [13] in Osun both in South West Nigeria; oligospermiccases were reported as 51% [11], 46.5% [13], 45.3% in Ilorin,North-Central Nigeria [14], 60% [11] in Enugu ,Eastern Nigeriaare in synchrony with the present study. However, in Tunisia,North Africa was a 13% [15] lower in rate of oligospermia.Azoospermia categorically can be responsible for any couple's inferlity,  since it is complete sterility, while oligospermia onlydecreases the chancesof ferlizaon.  This  condion  mayresult from autoimmune natural sperm agglunanganbodies  in the serum of sub ferle  men [10].Only 40% of the sperm cells were mole  within one hour of  ejaculaon,  ten per cent non mole,  while remaining 50%were sluggish. Drake et al. [11] documented that bacterial infecons  could be responsible for decline in sperm molity.  Inearly infecon,  there may be normal sperm count and sperm molity  before the complicaon  sets in. Role of bacterial infecon  may include change in the chemical milieu of thesemen, inammatory  damage of the passage, destrucon  of the sperm cells and impede their molity.  The consequence istherefore, reduced sperm count, teratospermia andasthenospermia. Escherichia coli have been found to decreasesperm molity  and cause agglunaon  [11,16].The male reproducve  tract is essenally  sterile except thelower urethra. Hence, greater than 2000 pus cells per ml of semen may be signicant  for diagnosis of infecon  [10]. Thepresence of certain organisms in semen or high number of theorganisms is associated with inferlity  [17]. In the presentstudy, 42% (N=150/360) of the semen samples had signicant pus cells (≥2000 cells per ml) and pathogens were isolated inonly 47% (N=70/150) of these samples. The y-  three percent (N=80/150) rate of sterile culture samples with signicant pus cells is a pointer to reckless anbioc  usage in Nigeria [13,18]. This ‘culture-negave  semen' challenge can be solved bythe introducon  of non-culture diagnoscs. The 19% (N=70/360) of the semen contained total numberof isolates was as follows, S. aureus  (53%), E. coli   (11.4%), S. saprophytcus  (10%), Klebsiella spp  (7.1%), P. aeruginosa (7.1%), Candida spp  (7.1%) and S. pneumoniae  ( 4.4%) indescending order. The above data are comparable to studiesby Orji et al. [16] and Olajubu et al. [11] which idened   S.aureus  as the commonest isolated bacteria with 37.1% and51% respecvely  unlike a study [10] which found E. coli   as themost prevalent with 70.4%. The isolaon  of S. aureus  mighthave resulted from the skin ora  of the couples. However,cross- infecon  might be a factor in some partners “tryingoutside marriage” [16]. Sex preferences may as well inuence the nature and types of isolates in the semen [17,18]. Forinstance, anal sex may result in the transmission of bacteriawhich are normal ora  of the intesne. The most acve   anbiocs  tested against the various typesof bacterial isolates includes, Moxioxacin  (85%), Levooxacin (80%), Ceazidime  (80%), Ceriaxone  (80%). However, someolder and commonly used anbiocs,  Penicillin (20%) andTetracycline (10%) have been noted to be crying orphans withlow acvity.  Some usually acve   anbiocs,   Ciprooxacin (70%), Ooxacin  (68%) and Gentamicin (60%) have turned to Archives of Clinical MicrobiologyISSN 1989-8436  Vol.7 No.4:27 2016 © Copyright iMedPub  3  be moderately eecve.  The newer generaon   anbiocs  are relavely  expensive and are mostly given in hospitals.Therefore, they are not easily reached by the people. Table 2   Anbioc   suscepbility   paern  of the isolates from infected semen of the subjects Drugs Bacterial Isolates ** S. aureus 37 (%) S. saprophyticus 7 (%) E. coli  8 (%) Klebsiella spp. 5 (%) P. aeruginosa 5 (%) S. pneumonia 3 (%) *  AMP10 (27)--3 (60)1(20)1 (33)PEN8 (22)0 (0)2 (25)1 (20)-1 (33) AMX----1 (20)-SXT11 (30)3 (43)2 (25)--2 (66)TCN---0 (0)1 (20)-GENT25 (68)5 (71)4 (50)3 (60)2 (40)2 (66)ERYTH12 (32)1 (14)3 (38)-0 (0)-MOXI35 (95)7 (100)-4 (80)--CEFTR33 (89)-6 (75)--3 (100)CEFT-7 (100)-4 (80)3 (60)-CIPRO32 (87)6 (86)5 (63)3 (60)-2 (66)OFL30 (81)6 (86)--3 (60)-LEV34 (92)-7 (88)4 (80)3 (60)3 (100) *  AMP=Ampicillin; PEN=Penicillin; AMX=Amoxicillin; MOXI=Moxifloxacin; TCN=Tetracycline; GENT=Gentamicin; ERYTH=Erythromycin; SXT=Trimethoprim-Sulphamethoxazole; CEFTR=Ceftriaxone; CEFT=Ceftazidime; CIPRO=Ciprofloxacin; OFL=Ofloxacin; LEV=Levofloxacin; ** S. aureus = Staphylococcus aureus ; S. pneumoniae = Streptococcus pneumoniae ; E.coli  = Escherichia coli  ; spp=species Male inferlity  has largely been aributed  to nonspecic seminal tract infecon  [17,18]. Alausa and Osoba for inferlity [9], discovered that 40% of oligospermia and azoospermiacases presenng  to ferlity  clinics in Lagos Nigeria gave ahistory of two or more aack  of urethris.   Ferlity  is jeopardized by these infecons  in several ways by decreasingsperm molity,  changing the chemical milieu of the seminal uid  or illicit some inammatory  changes in seminal tract.Bacterial presence may cause tescular  damage or the obstrucon  of the sperm ducts leading to low sperm count.Chronicity of some urinary tract infecon  is traceable toseminal infecon  by acng  as a reservoir of infecon  [19].In excepon  to infecons,  other condions  can beincriminated in male inferlity.  Such condions  like, exposureto heavy metals e.g. lead, zinc and arsenic. Others include;heat, chemical, X-ray exposure, smoking, nutrionaldeciencies  and use of alcohol, tobacco and caeine.  Also,many recreaonal  and prescripon  drugs (e.g. nitro furans, cimedine),  some herbal medicines (such as St. John's wort)and specic  herbicides and pescides  have been found to betoxic to spermatogenesis. However, the correlaons  are dicult  to develop, as supporng  evidence is sketchy[9,18,19].An automated system example, Computer-Assisted SpermAnalysis (CASA), would have given us a beer  analysis of sperm molity  and other parameters may be a limitaon  tothe study. Intervenons  should be focused at prevenon  since surgicaltreatment of inferlity  and Assisted Reproducve  Techniques(ARTs) are beyond the reach of many in Africa. Therefore,regular microbiologic screening and invesgaon  for inferlity is advised in this sub region. References 1. World Health Organizaon  (2010) WHO Laboratory Manual forthe Examinaon  and Processing of Human Semen. (5thEdn),Cambridge University Press, Cambridge, UK. 2. Jimoh AA (2002) The Management of Inferlity  in Africa.Medilorin Journal 1: 3-9. 3. Hauser R, Paz G, Botchan A, Yoger L, Yaretz H (2001) Varicocele: Eect  on Sperm Funcons.  Human Reproducon  Update 7:482-485. 4. Kenkel S, Rolf C, Nieschlag E (2001) Occupaonal  Risks for Male Ferlity:  An Analysis of Paents   Aending  a Terary  ReferralCenter. Internaonal  Journal of Andrology 24: 318-326. 5. Jeyendra RS (2001) Semen analysis: method and interpretaon. In:Gynaecology and Obstetrics. Sciarra JJ, Lipincot Williams andWilkins 5: 4-20. Archives of Clinical MicrobiologyISSN 1989-8436  Vol.7 No.4:27 2016 4 This article is available from: http://www.acmicrob.com  6. Budia A, Luis PJ, Broseta E, Tejadios S, Benedicto A, et al. (2006)Value of Semen Culture in the Diagnosis of Chronic Bacterial Prosas  : A Simplied  Method. Scandinavian Journal of Urology &. Nephrology 40: 326-331. 7.  Pella  D, Mylonakis I, Bertoloni G, Fiore C, Andrisani A, et al.(2008) Genital Tract Infecons  and Inferlity.  European Journalof Obstetrics& Gyneacologic Reproducve  Biology 140: 3-11. 8. Sanocka-Maciejewsky D, Ciupinska M, Kurpisz M (2005)Bacterial Infecon  and Semen Quality. Journal of Reproducve immunology 67: 51-56. 9. Ekhaise FO, Richard FR (2008) Common Bacterial IsolatesAssociated with Semen of Men Complaining of Inferlity  inUniversity of Benin Teaching Hospital (U.B.T.H), Benin City,Nigeria. World Journal of Medical Sciences 3: 28-33. 10. Alo MN, Ugah UI, Elom MO (2013) Semen Culture: A Comparave  Analysis between Solid Media and Liquid Media Supplementaon  . IOSR Journal of Pharmacy and BiologicalSciences 5: 67-72. 11. Festus AO, Deji-Agboola M, Olubunmi AO, Olusoji EJ (2013)Seminal Fluid Characteriscs  of Men Aending   Inferlity  Clinicof a Teaching Hospital. Open Journal of Medical Microbiology 3:1-4. 12. Clinical Laboratory Standard Instute  (2007) Performancestandard for anmicrobial  disk suscepbility  tests. 13. Kosamat YA, Adebolu TT (2005) Bacteriological study of isolatesfrom seminal uids  of inferle  men in Ila and Ifedore localgovernment areas, Osun State, South-Western Nigeria. Journalof Food, Agriculture & Environment 3: 73-74. 14. Nwabuisi C, Onile BA (2001) Male Inferlity  among Sexually Transmied  Disease Clinic Aendees  in Ilorin. Nigerian Journalof Medicine 10: 68-71. 15. Gdoura R, Keskes-Ammar L, Bouzid F (2001) Chlamydia trachomas  and Male Inferlity  in Tunisia. European Journal of  Contracepon  and Reproducve  Health Care 6: 102-107. 16. Orji I, Ezeifeka G, Amadi ES, Okafor F (2007) Role of Enrichedmedia in Bacterial Isolaon  from Semen and Eect  of Microbial Infecon  on Semen Quality: A Study on 100 Inferle  men.Pakistan Journal of Medical Sciences 23: 855-888. 17.  Coell  E, Harrison RF, McCarey  M, Walsh T, Mallon E (2000)Microorganisms are commonly found in insignicant   quanes in the semen of asymptomac  men. African Journal of Ferlity and Sterility 74: 465-470. 18. Onemu SO, Ibeh IN (2001) Studies on the Signicance  of Posive Bacterial Semen Cultures in Male Ferlity  in Nigeria. Internaonal  Journal of Ferlity  and Women’s Medicine 46:210-214. 19. Audu BM, Massa AA, Bukar M, Melah GS, Kudi A (2010). Eect of bacterial isolates on the seminal indices of men invesgated for inferlity  in Gombe. Nigerian Journal of Clinical Pracce  13:16-19.   Archives of Clinical MicrobiologyISSN 1989-8436  Vol.7 No.4:27 2016 © Copyright iMedPub  5
Search
Similar documents
Tags
Related Search
We Need Your Support
Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

Thanks to everyone for your continued support.

No, Thanks
SAVE OUR EARTH

We need your sign to support Project to invent "SMART AND CONTROLLABLE REFLECTIVE BALLOONS" to cover the Sun and Save Our Earth.

More details...

Sign Now!

We are very appreciated for your Prompt Action!

x