title: Microbial evaluation and public health implications of urine as alternative therapy in clinical pediatric cases: health implication of urine therapy.
abstract: BACKGROUND
  Cultural means of pediatric treatment during ill health is a mainstay in Africa, and though urine has been known to contain enteric pathogens, urine therapy is still culturally applicable in some health conditions and also advocated as alternative therapy. The study therefore, is to evaluate the microbial contents and safety of urine.
  
  
  METHODS
  Urinary bacteria from cows and healthy children aged 5-11 years were identified by conventional phenotypic methods and antimicrobial susceptibility testing was performed using modified agar disc and well-diffusion methods.
  
  
  RESULTS
  A total of 116 bacterial isolates (n = 77 children; n = 39 cows) were identified as Bacillus (10.4%; 5.1%)), Staphylococcus (2.6%; 2.6%), Citrobacter (3.9%; 12.8%), Escherichia coli (36.4%; 23.1%), Klebsiella (7.8%; 12.8%), Proteus (18.2%; 23.1%), Pseudomonas (9.1%; 2.6%), Salmonella (3.9%; 5.1%) and Shigella (7.8%; 12.8%) spp. Antibiotic resistance rates of the Gram-positive bacteria were high (50.0100%), except in Bacillus strains against chloramphenicol, gentamicin and tetracycline (14.3%), while higher resistance rates were recorded among the Gram-negative bacteria except in Citrobacter (0.0%) and Proteus (8.5%) spp. against gentamicin and tetracycline respectively. The Gram-negative bacteria from ito malu (cow urine) were more resistant bacteria except in Citrobacter (20.0%) and Shigella spp. (0.0%) against tetracycline and Proteus spp. (11.1%), (22.2%) against amoxicillin and tetracycline respectively. Multiple antibiotic resistance (MAR) rates recorded in children urinal bacterial species were 37.5-100% (Gram-positive) and 12.5-100% (Gram-negative), while MAR among the cow urinal bacteria was 12.5-75.0% (Gram-positive) and 25.0-100% (Gram-negative). Similar higher resistance rates were also recorded among the Gram-negative bacterial species from urine specimens against the pediatric antibiotic suspensions.
  
  
  CONCLUSIONS
  The study reported presence of multiple antibiotic-resistant indicator bacteria in human urine and ito malu used as alternative remedy in pediatric health conditions like febrile convulsion.
authors.affiliation: Applied Microbiology and Infectious Diseases Unit, Department of Botany and Microbiology, University of Ibadan, Ibadan, Oyo State, Nigeria.
authors.forename: Adenike Adedayo O
authors.initials: AA
authors.lastname: Ogunshe
authors.forename: Abosede Oyeyemi
authors.initials: AO
authors.lastname: Fawole
authors.forename: Victoria Abosede
authors.initials: VA
authors.lastname: Ajayi
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D016488:Medicine, African Traditional; D008826:Microbial Sensitivity Tests; D010372:Pediatrics; D011634:Public Health; D003294:Seizures, Febrile / Q000628:therapy; D014556:Urine / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents