Abstract
Background: Urinary tract infections are major causes of morbidity in people living with HIV. Hence the study aimed to determine the prevalence of bacteriuria and their antibiotic susceptibility patterns among people living with HIV. Method: A prospective cross-sectional study conducted from April to June 2015. A total of 297 and153 participants were from Zewditu Memorial Hospital and Tikur Anbessa Specialized Hospital, respectively. First morning urine samples were collected and cultured on Blood and MacConkey agar. Culture positives were characterized by Gram stain and standard biochemical tests and Kirby-Bauer method was used for antimicrobial susceptibility patterns of the isolates. Chi-square test was used to see the relation between dependent variables and independent variables. P-value <0.05 were taken as statistically significance. Data was entered and analyzed using SPSS version 20. Result: Overall prevalence of bacteriuria was 11.3% (n=51/450). Isolated bacteria from HAART naive and on HAART participants were 7% (n=9/131) and 13% (n=42/319) respectively. E. coli 25(49%), S. aureus 10(19.6%) and Enterococcus species 7 (13.7%) were the predominant isolated bacteria. The highest proportion of bacteria were isolated from patients having a CD4 count of less than 500 cells/mm3 (22.5%; n=38/169). Most bacterial isolates were sensitive to amikacin (100%), ceftriaxone (96%); resistant to ampicillin (81%), sulfamethoxazole-trimethoprim (71%) and amoxicillin-clavulanic acid (61%). Multiple drug resistance was 78.4% (n=40/51). Gram positives and gram negatives accounts 65% (n=13/20) and 87% (n=27/31) of multiple drug resistance level respectively. Conclusion: HAART users with low CD4 counts were more frequently infected with urinary pathogens compared with HAART naive who had higher CD4 counts. More than three quarters of all isolated bacteria were resistant to two or more commonly prescribed antimicrobial drugs. Thus, regular monitoring of bacteriuria and their antimicrobial susceptibility patterns among this group of individuals is recommended to provide effective therapy and thereby prevent renal complications.
Highlights
HAART users with low CD4 counts were more frequently infected with urinary pathogens compared with HAART naïve who had higher CD4 counts
Urinary tract infection (UTI) refers to the presence of microbial pathogens within the urinary tract and is usually classified by the site of infection: bladder [cystitis], kidney [pyelonephritis], UTI always requires the presence of bacteria in the urine, but can be both asymptomatic or symptomatic, and is characterized by a wide spectrum of symptoms ranging from mild irritative voiding to bacteremia, sepsis, or even death [1]
We found asymptomatic bacteriuria rate of 7% (n=29/398) which was comparable to findings of other studies in Ethiopia [14]
Summary
Urinary tract infection (UTI) refers to the presence of microbial pathogens within the urinary tract and is usually classified by the site of infection: bladder [cystitis], kidney [pyelonephritis], UTI always requires the presence of bacteria in the urine (bacteriuria), but can be both asymptomatic or symptomatic, and is characterized by a wide spectrum of symptoms ranging from mild irritative voiding to bacteremia, sepsis, or even death [1]. Untreated UTIs account for 7-60% of opportunistic infections and could be a source for ascending urinary tract infection and septicemia in immunocompromised hosts [3]. Urinary tract infections are major causes of morbidity in people living with HIV.
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