Omosigho O P
Medical Microbiology Department, Federal Medical Centre Bida. Niger State .Nigeria
Emumwen E.G, Inyinbor H.E
Medical Microbiology Dept., Federal Medical Centre Bida. Niger State Nigeria.
All correspondents to: Medical Microbiology Department, Federal Medical Centre Bida. Niger State, Nigeria. Email –firstname.lastname@example.org
Male urogenital tract infection is an important factor in the management of infertility. This study was carried out to evaluate the prevalence of bacteriospermia, antibiotic susceptibility pattern and its effect on the quality of spermatozoa in male infertility in Bida. Five hundred and six semen samples cultured in the medical microbiology laboratory for three years were analyzed. This study showed a prevalence of bacteriospermia of 39.9% with Staphylococcus aureus having the highest frequency of 30.4%. Bacterial infection has remained one of the important factor in the management of infertility ,this study showed high rate of bacteriospermia in primary infertility 27.7% which is statistically significant (P= 0.000). The prevalence of bacteriospermia in Bida was more pronounced in oligospermia 22.7%. This study found a significant statistical difference between bacteriospermia and age (P=0.000) .In conclusion, the prevalence of bacteriospermia is high in Bida, it is therefore advocated that attention should be given to the treatment of urogenital infection in the management of male factor infertility.
KEY WORDS-Bacteriospermia, Staphylococcus aureus, Antibiotic susceptibility, Male factor, Infertility.
According to World Health Organization (WHO), seminal fluid infection was define as the presence of significant bacteriospermia (= 103 bacterial/ml ejaculate), detection of Nisseria gonorrhoae, Chlamydia trachomatis, Ureaplasma urealyticum, significant leucocytospermia (WHO 1999).
The isolation of microorganisms in seminal fluid especially of infertile men has been widely reported, while the exact role of microbial infection in the etiology of infertility is not very certain owing to the limitation in diagnostic criteria and asymptomatic nature of infection, as some possible effect on the properties of seminal fluid associated with fertility has been suggested (Gregoriov et al .,1989, Merino et al., 1995, Villanueva-Diaz et al., 1999, Purvis and Christiansen1993, Buhharin et a.,l 2000 and Rodin et al., 2003 ).
There is disagreement as to the influence of certain microbial infection on male infertility, several investigation have reported different types of organisms in seminal fluid specimens depending on the method of examination (Macleod and Gold 1951). It was reported that detection of bacteria in semen does not necessary suggest
infection since bacteria isolates in seminal fluid may represent contamination, colonization of urethral orifice or infection. Opportunistic microorganism cause classical infection of urogenital tract and subclinical reproductive tract infection, these infections of the seminal fluid leads to decrease in number of spermatozoa, the suppression of their motility, changes their morphology and fertility capacity (Buhharin et al., 2000).
This study was carried out to evaluate the prevalence of bacteriospermia, antibiotic susceptibility patterns and its effect on the quality of spermatozoa in male infertility in Bida, Niger State.
MATERIALS AND METHOD
Five hundred and six (506) seminal fluids from men investigated for infertility over a period of three years were analyzed. These were seminal fluid of patient referred to the Laboratory from the Gynecology Clinic of Federal Medical Centre, Bida.
The semen was collected after the patient had abstained from sex at least three days. Samples were collected either by self or assisted masturbation into sterile bottle. Patients were educated on proper sample collection to reduce contamination and submitted to the Laboratory within one hour of production. The semen were cultured on Blood, Chocolate and MacConkey agar media and incubated for 24 hours at 37oC while Chocolate agar were incubated under 5% Co2. Emergent colonies were identified according to standard bacteriological method.
The samples were analyzed within one hour of collection or as soon as liquefaction occurred using manual method.
Initial microscopy examination of the appearance, viscosity and volume estimation was done, after which microscopy was carried out to estimate the sperm concentration, motility and morphology according to WHO guideline (WHO 2010).
Male genital tract infection is an important etiological factor leading to deterioration of spermatogenesis, impairment of sperm function and/or obstruction of seminal tract (Owolabi et al., 2013). The prevalence of bacteriospermia among male partners of infertile couples in this study is 39.9% with Staphylococcus aureus having the highest frequency of 154(30.4%) followed by Eschericia coli 34(6.7%) and Pseudomonas aeruginosa 7(1.2%) which is in agreement with other studies in Nigeria (Ibekwe and Mbazor 2002 in Abakeliki , Ugboma et al., 2012 in Port Harcout and Emokpae et al ., 2009 in Kano).
Generally ,the risk of infertility increases by age, in this study a high bacteriospermia prevalence rate was obtained among age 36-40 years (12.4%) followed by age 26-30 years (9.2%) and 31-35 years (8.8%) this findings is statistically significant (p=0.000) and agrees with the findings in Port Harcourt Nigeria (Olutimilehin et al .,2012).
Infection has remained one of the important factors in infertility our findings showed a higher rate of bacteriospermia in primary infertile couples 27.7% compared to 12.3% in secondary infertility and it is found to be statistically significant(p=0.000) though, in contrast to the findings of Olujubu et al., (2013)who reported a higher prevalence in secondary infertility.
Bacteriospermia was more pronounced in couples with oligospermia 22.7% followed by normospermia 10.5% and azoospermia 6.7% similar to the findings in Kano by Emokpae et al .,2009, while Owolabi et al ., in Ile ife reported 50.2% seminal infection in normospermia ,20.3% in oligospermia and 4.4% in azoospermia.
Antibiotic susceptibility pattern of bacteriospermia in Bida from our study shows that all isolates are 70-90% susceptible to Levofloxacin, Ciprofloxacin, Pefloxacin and Azithromycin while many are resistant to Gentamycin , Cefuroxime, Ceftazidime and Cotrimoxazole.
In conclusion, the prevalence of bacteria in semen may affect fertility in several ways including damage of spermatozoa, hampering their motility, altering the chemical composition of fluid (Mogra et al., 1981). Bacterial infection in this study is high and we advocate that proper attention should be given to the treatment of bacteriospermia in the management of male factor cause of infertility.