Asymptomatic Bacteriuria in Hiv/Aids Patients: Occurrence and Risk Associated With Low Cd4 Counts.

Abstract

BACKGROUND:People living with HIV/AIDS with progressive immune dysfunction have an augmented risk of Urinary tract infection, both symptomatic and asymptomatic, in comparison to non-infected individuals. AIMS: This prospective study was planned to know the frequency of asymptomatic bacteruria (ASB) in HIV sero-positives and its correlation to their immune status. Conventional culture method was compared with screening test using SD Urocolor TM 10 test strips for the presence of infection. Antibiogram of isolated uropathogens were analysed to understand the trends of drug resistance. SETTINGS AND DESIGN: Prospective Cohort Study. MATERIALS AND METHODS:Clean catch midstream urine samples collected from 270 HIV seropositive patients and 100 seronegative controls were screened for ASB by Urostrip urinalysis, Gram stain and culture. Antibiogram of significant growth isolates was done by Kirby-Bauer disc diffusion method. Their immune status was evaluated by CD4 + cell counting. STATISTICAL ANALYSIS USED: Sensitivity, Specificity, Odds ratio, Fisher extract test. RESULTS: ASB was detected in 5.6% (15/270) of HIV sero-positives and 1% (1/100) of seronegatives controls.13/15 HIV seropositive ASB cases had CD4 cell counts < 350 cells/ μL. The gram stain and urostrips had sensitivity of 93.33% & 80% and a specificity of 95.68% & 60.39% respectively. CONCLUSIONS: Occurrence of ASB was significantly high among the HIV sero-positives with CD4 cell counts < 350 cells/ μL. Conventional culture and gram staining continue to be the proficient methods for detecting ASB. Cotrimaxazole prophylaxis hardly influenced the presence of ASB in HIV sero-positives.

Prevalence and antibiotic susceptibility pattern of bacteriuria among HIV-seropositive patients attending the Bamenda Regional Hospital, Cameroon

“…Our study has generated data for HIV- seropositive patients in this part of the country where information on bacteriuria among HIV- seropositive patients is scarce. When our findings was compared to those of other countries, the prevalence we recorded is higher than those observed in different parts of Nigeria (10.9% and 57.3), Ethiopia (9.2% and 11.3%), South Africa (37.6%)and India 3 , 4 , 10 , 14 – 16 . Our observation on female being more infected is consistent with almost all the studies we have come across 5 , 6 , 24 .…”

Prevalence, Antimicrobial Susceptibility Pattern of Bacterial Isolates, and Associated Factors of Urinary Tract Infections among HIV‐Positive Patients at Hiwot Fana Specialized University Hospital, Eastern Ethiopia

“…Multidrug resistance has serious implications on the health outcome of HIV-infected patients [9, 25]. It is quite alarming to note that almost 46% of the isolates in this study were found to be resistant to two or more antimicrobials.…”

“…The health consequences of UTI among HIV-infected patients can be grave, resulting in acute and chronic kidney diseases [7], infertility, cancer, sepsis, and neurologic complication, which lead to urinary stasis [8, 9]. Some of the patients may substantially suffer from financial burden not only because of the recurrence of UTI but also due to the use of expensive antimicrobials, longer duration hospitalization, adverse drug effects, and unsatisfactory therapeutic options [7, 10].…”

<p>Isolation and Antibiotic Susceptibility Pattern of Bacterial Uropathogens and Associated Factors Among Adult People Living with HIV/AIDS Attending the HIV Center at Wolaita Sodo University Teaching Referral Hospital, South Ethiopia</p>

“…HIV infection is associated with a variety of renal syndromes; patients with low CD4 counts are at risk of the neurological complications of hyperreflexia and hyporeflexia which can lead to urinary stasis and ultimately infection. 7 The emergence of antibiotic resistance in the management of UTIs is a serious public health problem globally, particularly in the developing world. 8 Since bacterial pathogens of UTIs are variable regionally, infection control and treatment depend on local knowledge of common causative organisms and their antibiotic resistance.…”