Abstract
People living with human immunodeficiency virus (HIV) are more likely to develop urinary tract infections (UTI) due to the suppression of their immunity. The aim of this study was to determine the prevalence, risk factors of UTI, and drug susceptibility pattern of bacteria isolated among peoples infected with HIV. A hospital-based cross-sectional study was conducted among 224 HIV positive individuals attending Hawassa University Comprehensive Specialized Hospital (HUCSH) from September 17 to November 16, 2018. Midstream urine was collected from all study participants and inoculated on to Blood and MacConkey agar. Bacterial isolates were characterized by Gram stain and standard biochemical tests. Kirby-Bauer method was used for antimicrobial susceptibility testing. Sociodemographic and clinical data were collected by a semi-structured questionnaire. Data were analyzed using SPSS version 20. A bivariate and a multivariable regression model were employed to determine the association between dependent and independent variables. From the total 224 study participants, 23 (10.3%) (95% CI 6.7–14.7) had culture-confirmed UTIs. The distributions of the bacteria were as follows: Escherichia coli 16 (69.6%), Staphylococcus aureus 2 (8.7%), Klebsiella pneumoniae 2 (8.7%), Enterobacter aerogenes 2 (8.7%) and Pseudomonas species 1 (4.3%). UTI prevalence was also high among study participants with a previous history of UTI and CD4+ count < 200/mm3. Female study participants were about five times more likely to have UTI (AOR 5.3, 95% CI 1.5–19.2). Ninety-three percent of bacteria isolated were susceptible to nitrofurantoin, ceftriaxone, and gentamycin; 87.5% were susceptible to meropenem and norfloxacin; whereas 93.8%, 68.8%, and 62.5% of isolates were resistant to ampicillin, tetracycline, and cotrimoxazole respectively. Multidrug resistance (MDR) was seen in 18 (78.3%) of bacterial isolates.
Highlights
AIDS Acquired immune deficiency syndrome ART Antiretroviral therapy ASB Asymptomatic bacteriuria Human Immunodeficiency Virus (HIV) Human immunodeficiency virus UTI Urinary tract infection HUCSH Hawassa University Comprehensive Specialized Hospital Multidrug resistance (MDR) Multi drug-resistant
There are scarce data regarding the causative agents of UTI among HIV positive individuals from the study area; this study was conducted to determine the prevalence of bacterial UTI, risk factors and drug susceptibility pattern of isolates among adult people living with HIV attending HUCSH, Hawassa Ethiopia
The overall prevalence of UTI among people living with HIV was 10.3%
Summary
AIDS Acquired immune deficiency syndrome ART Antiretroviral therapy ASB Asymptomatic bacteriuria HIV Human immunodeficiency virus UTI Urinary tract infection HUCSH Hawassa University Comprehensive Specialized Hospital MDR Multi drug-resistant. Urinary tract infection (UTI) is an important health problem that can affect HIV positive individuals. Several bacteria and some fungus cause UTI among HIV-infected p ersons[9,10]. UTI commonly affect femalses than males among general population and among HIV infected population[22]. Management of other non-HIV associated diseases including UTI in people living with HIV has become increasingly important It is complicated by emergence of antibiotic resistant bacteria making treatment of UTI challenging. In these regard, UTI co-infection with HIV is becoming a major challenge and leads to additional c osts[8,18]. There are scarce data regarding the causative agents of UTI among HIV positive individuals from the study area; this study was conducted to determine the prevalence of bacterial UTI, risk factors and drug susceptibility pattern of isolates among adult people living with HIV attending HUCSH, Hawassa Ethiopia
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