Asymptomatic urinary tract infection with multidrug resistant pathogens in retro positive patients on ART
Abstract
Introduction: Asymptomatic urinary tract infection refers to occurrence of bacteria in urine without causing symptoms. UTI is more prevalent among retro positive patients compared to people without HIV. Objectives – The study was done to determine prevalence of UTI, common etiologies and antibiotic susceptibility pattern of urinary isolates among HIV seropositive patients attending ART centre for CD4 counts.
Materials & Methods: –A total of 109 patients without any symptoms of UTI were included in the study. AST was done using Kirby Bauer disk diffusion method.CD4 count was done using FACS counter.
Results: Out of the 109 cases tested, 55 were males, and 54 cases were females. No growth was seen in 60 (55.04%) samples, insignificant bacteriuria in 9(8.26%) samples. Significant growth was seen in 40 samples (36.7%). Among the 54 females, 44% had significant growth. Among 55 males, significant growth was seen in 29.1%. The isolated organisms included Escherichia coli - 9(22.5%), Staphylococcus aureus - 7(17.5%), Candida albicans - 7(17.5%). Bacterial isolates showing resistance to three or more categories of antibiotics were considered Multidrug resistant (MDR). Multidrug resistance was seen among 16 bacterial isolates (48.5%). HIV positive patients with CD4 counts of <200 had higher rates of asymptomatic bacteriuria.
Conclusion: Screening of HIV seropositive patients with lower CD4 counts for asymptomatic UTI helps in early diagnosis and appropriate, early management of MDR will reduce morbidity.
Downloads
References
Okolie MN, Eghafona NO, Omeregie R. Anti human immunodeficiency virus agents. J Med Lab Sci 2003; vol-12(1): 1-14.
Rashmi KS, Ravikumar KL, Jagadeesh, Namitha , Bhagyashree HN, Asymptomatic bacteriuria in HIV/AIDS patients: Occurrence and risks associated with low CD4 counts. JEMDS,2013;2(19):3358-3366.
Iweriebor BC, Obi CL, Akinyemi O, Uropathogens isolated from HIV infected patients from Limpopo province, South Africa. Afr J Biotech 2012;vol 11 , No. 46: 10598-10604.
Biradar Sk, Srikanth , Doddamani PK, Prevalence and antibiogram of uropathogens in a tertiary care hospital. World Journal of Pharmaceutical Research 2015 vol4 ,issue 1 : 1534-1543.
Schönwald S, Begovac J, Skerk V. Urinary tract infections in HIV disease. Int J Antimicrob Agents. 1999 May;11(3-4):309-11.
J G Collee; T J Mackie; J E McCartney , Practical Medical Microbiology ,Churchill livingstone, New York, 14th Edition.
Clinical and laboratory standards institute guidelines, CLSI 2016.
Iroha Ifeanyichukwu, Nwakeze Emmanuel, Ejikeugwu Chika, Oji Anthonia, Udu-Ibiam Esther, Afiukwa Ngozi, Ngwu Justina. Frequency and Antibiogram of Uropathogens Isolated from Urine Samples of HIV Infected Patients on Antiretroviral Therapy. American Journal of BioScience. Vol. 1, No. 3, 2013, pp. 50-53. doi: https://doi.org/10.11648/j.ajbio.20130103.11.
U.C. Essien, C.C. Iheukwumere , G.I. Davou , Z. Sheyin , C.E. Okolie , F.R. Ede and A.I. Ekwempu. : Prevalence and Predictors of Asymptomatic Urinary Tract Infection among HIV Positive Patients in Jos, North Central Nigeria. Int.J.Curr.Microbiol.App.Sci (2015) 4(9): 454-462.
Kemajou TS, Ajugwo AO, Oshoma CE, Enabulele OI. Antibiotic Resistance of Bacterial Isolates from HIV Positive Patients with Urinary Tract Infection (UTI) in Portharcourt, Nigeria.x J AIDS Clin Res 7:594. doi: https://doi.org/10.4172/2155-6113.1000594
Inyang –Etoh PC, Udofia GC, Alaribe AAA, Udonwa NE. Asymptomatic bacteriuria in patients on anti retroviral drug therapy in Calabar. J Med Sci.2009;vol9:270-5.
Spence MR, Harwell TS, Jones K,. Asymptomatic bacteriuria in women infected with HIV – Int Conf AIDS . 1996;11:283.
Michael IO, Abel O, Ukoh G. Urinary tract infections in adolescent/young adult Nigerians with acquired immunodeficiency disease in Benin city. J Mol Biol Res 2006;5:55-60.
Widmer TA, Theron G, Grove D. Prevalence and risks of asymptomatic bacteriuria among HIV positive pregnant women. South Afr J Epidemiol Infect 2010;25:28-32.
Foxman B. Epidemiology of UTI. Incidence, morbidity and economic costs. Am J Med 2002 july; 113:55-135.
Hochreiter WW, Bushman W. Urinary tract infection: a moving target. World J Urol. 1999 Dec;17(6):364-71.
Omoregie R, Eghafona NO. Urinary tract infection among asymptomatic HIV patients in Benin City, Nigeria. Br J Biomed Sci. 2009;66(4):190-3.
Banu A, Jyothi R. Asymptomatic bacteriuria in HIV positive Individuals in a tertiary care hospital. Journal of HIV & human reproduction. 2013;1(2): 54-57.
Murugesh K ,Deepa S, Ravindranath C , Venkatesha D. : Multidrug resistant uropathogen in HIV is a threat to the community. International Journal of scientific study 2014;2(3):38-42.
OAI - Open Archives Initiative
