Bacteriospermia,extended spectrum beta lactamase producing Gram-negative bacteria and other factors associated with male infertility in Mwanza,Tanzania: a need of diagnostic bacteriology for management of male infertility

BackgroundInfections caused by Extended spectrum beta lactamase (ESBL) producing bacterial are global challenge. There is limited information on the magnitude of bacteriospermia, ESBL producing Gram-negative bacteria (GNB) causing bacteriospermia and factors associated with male infertility. This study determined magnitude of bacteriospermia, ESBL-GNB and other factors association with infertility among presumptive infertile men in Mwanza, Tanzania.MethodsA cross-sectional hospital-based study was conducted between May 2017 and July 2018 among 137 presumptive infertile men. Semen specimens were self-collected by masturbation into clean, sterile and none-spermicidal containers and processed following laboratory standard operating procedures (SOPs). Data analysis was done using STATA 13.0.ResultsGram-negative bacteria were predominantly isolated (86.4%), of which 31.6% were ESBL producers. In a total 44 bacteria were isolated from semen culture. The blaCTX-M gene was detected in 75% of phenotypically confirmed ESBL producers. Infertility was independently found to be associated with abnormal spermatozoa morphology (OR (95%CI): 14.48(3.17–66.05)) and abnormal spermatozoa motility (OR (95%CI): 0.05(0.01–0.24)). However, neither bacteriospermia (OR (95%CI): 0.86(0.29–2.59)) nor ESBL bacteriospermia (OR (95%CI): 0.13(0.01–1.22)) was found to be associated with infertility.ConclusionOne third of bacteriospermia is due to ESBL-producers with history of antibiotic use being protective factor for infertility. Abnormal spermatozoa morphology and poor spermatozoa forward motility independently predicted infertility.