Factors associated with urinary tract infections among HIV-1 infected patients

Skrzat‐Klapaczyńska, Agata; Matłosz, Bartłomiej; Bednarska, Agnieszka; Paciorek, Marcin; Firląg-Burkacka, Ewa; Horban, Andrzéj; Kowalska, Justyna D.

doi:10.1371/journal.pone.0190564

Cited by 20 publications

(29 citation statements)

References 31 publications

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“…Subjects with isolates in their urine had significantly lower CD4 cell count and higher VL than those without isolates; 838.6±177.8 vs 1009.9±234.7 cells/μl (p=0.02) for CD4 cell count, and 10,360.5± 471.0 vs 5,840.8±563.8 copies/ml, (p=0.003) for VL. This is similar to findings of other studies where significantly lower CD4 cell count and WHO stage 3 and 4 clinical disease consistent with high VL, was observed in infected children and adults with UTI (21,29,30). Iduoriyekemwen et al, (26) however did not make such observations among their study cohort in Nigeria.…”

Section: Discussionsupporting

confidence: 90%

“…While ofloxacin, nalidixic acid and cefuroxime were the most effective antibiotics invitro for the uropathogens in the present study, cotrimoxazole, ampicillin and piperacillin were the least effective. Similar patterns have been observed among isolates in different studies on HIV infected children and adults (12,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

Section: Discussionsupporting

confidence: 79%

“…The frequency of isolated bacteria from urine in our study compared favourably with those from other HIV studies in both children and adults across the globe (12,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). These uropathogens easily get access to the urinary space through retrograde ascent from the host's bowel (5,6) but could also result from nosocomial cause or from haematogenous seeding from distant sites.…”

Section: Discussionsupporting

confidence: 76%

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Bacteria urinary tract infection in HIV-infected children and adolescents in Abuja, Nigeria: a cross-sectional study

Aa¹,

Yunusa²

2019

Af J Clin Exp Micro

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Background: Urinary tract infection (UTI) remains the second commonest opportunistic infections among HIV infected children. This study was conducted to determine the prevalence and causative bacteria of UTI in HIV infected children and adolescents on antiretroviral medications in our health institution. Method: The study was a cross sectional design conducted between October 2017 and March 2018 among HIV infected children and adolescents aged 2 months to 18 years on follow up attendance at the Paediatric Outpatient Special Treatment Clinic (POSTC) of University of Abuja Teaching Hospital (UATH). Early morning midstream urine was collected from each participant for urinalysis, microscopy and aerobic bacterial culture. Bacteria were identified from culture by standard microbiological methods and antibiogram of the isolates was determined by the disk diffusion method. Result: Of 166 HIV infected children and adolescents studied, 106 (63.9%) were males, 82 (49.4%) were in age group 5-10 years, and 110 (66.3%) were from lower socioeconomic class. Significant bacteria (UTI) were isolated in 54 (32.5%) subjects, with 38 (70.4%) from females, and 51 (94.4%) from those on first line antiretroviral therapy. Isolates recovered were Escherichia coli 20 (37.0%), Klebsiella pneumoniae 16 (29.6%), Staphylococcus aureus 8 (14.8%), Pseudomonas aeruginosa 6 (11.1%), and Proteus mirabilis 4 (7.4%). Leucocyturia in 19 (35.2%), nitrituria in 10 (18.5%), and haematuria in 15 (27.8%) subjects with significant bacteriuria were also recorded. Isolates were sensitive to ofloxacin (81.5%), nalidixic acid (74.1%) and cefuroxime (61.1%), while they were resistant to cotrimoxazole (100%), ampicillin (98.1%) and piperacillin (94.4%). Significant difference was observed in the mean CD4 cell count and viral load of subjects with significant bacteriuria compared to those without; 838.6 ± 177.8 versus 1009.9 ± 234.7 cells/μL (p=0.02), and 10, 360.5 ± 471.0 versus 5, 840.8 ± 563.8 copies/ml (p=0.003) for CD4 cell count and viral load respectively. Conclusion: This study reported a high prevalence of UTI among HIV infected children and adolescents, especially in those with high viral load. Routine screening for UTI should be offered to HIV infected children and adolescents with high viral load.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 76%

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Bacteria urinary tract infection in HIV-infected children and adolescents in Abuja, Nigeria: a cross-sectional study

Aa¹,

Yunusa²

2019

Af J Clin Exp Micro

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“…The frequency of UTI is gradually increasing amongst HIV-infected patients as an opportunistic infection. This is due to the unique pathogenesis of the virus, which decreases the CD4 + cells, and as such, the individual's immune system can no longer fight against invading commensal organisms [2–4]. E. coli , Proteus spp., Klebsiella spp., Pseudomonas aeruginosa , Enterococcus spp., and S. aureus are the most causative agent of UTI in people living with HIV [5, 6].…”

Section: Introductionmentioning

confidence: 99%

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

Marami

Balakrishnan

Seyoum

2019

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Urinary tract infection remains a major public health problem in developing countries, where there are limited health-care services. Its prevalence is fueled by human immunodeficiency virus (HIV) infection. The emergence of antimicrobial resistance is now widespread and poses a serious clinical threat. This study investigated the prevalence, antimicrobial susceptibility pattern of bacterial isolates, and associated factors of urinary tract infections among HIV-positive adult patients. A cross-sectional study was conducted among 350 randomly selected HIV-positive patients at Hiwot Fana Specialized University Hospital from February to March 2016. Data were collected using a structured questionnaire. Clean-catch midstream urine samples were collected aseptically and examined using the recommended culture methods. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion technique. Data were analyzed using Statistical Package for the Social Sciences version 21.0. The logistic regression models were used to explore the predictors of the outcome. A p value < 0.05 was considered statistically significant. The overall prevalence of urinary tract infection was 18% (95% CI: 15.34–22.63). Individuals with age 35–44 years (Adjusted odds ratio (AOR): 4.07; 95% CI: 1.09, 5.10), income less than 46.7 USD (AOR: 2.76; 95% CI: 1.15, 6.07), and a CD4+ count less than 200 cells/mm3 (AOR: 2.07; 95% CI: 1.15, 3.73) had higher odds of UTI. Escherichia coli (38.1%), Klebsiella pneumoniae (23.8%), and Staphylococcus aureus (11.1%) were the predominant causes of urinary tract infection. E. coli was resistant to ampicillin (95.8%), ceftazidime (95.8%), cotrimoxazole (95.8%), amoxicillin (91.7%), ceftriaxone (87.5%), and tetracycline (87.2%). Multidrug resistance was observed in 46% of the isolates. The prevalence of urinary tract infection in this study was high compared to the previous reports in Ethiopia. Age 35–44 years, income less than 46.7 USD, and a CD4+ count < 200 cells/mm3 increase the odds of urinary tract infection. The most common isolates were E. coli, K. pneumoniae, and S. aureus. Almost half of the isolates were multidrug resistant. Actions to help mitigate the further spread of resistance are urgently needed in the study area.

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“…Other causes of kidney injury should also be considered (i.e. other drugs, illegal substances, comorbidities or urinary tract infections) (17).…”

Section: Introductionmentioning

confidence: 99%

Discontinuation of tenofovir due to nephrotoxicity: insight into 12 years of clinical practice

Matłosz¹,

Kowalska

Bąkowska³

et al. 2019

Przegl Epidemiol

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INTRODUCTION. Chronic kidney disease is a significant cause of morbidity and mortality among patients infected with human immunodeficiency virus (HIV). Tenofovir disoproxil fumarate (TDF) is widely used as the part of combination antiretroviral therapy (cART) and may cause renal function impairment. AIM. The primary objective of this analysis was to determine the rate of reversibility of kidney dysfunction and factors correlated with eGFR improvement in patients treated with TDF. MATERIALS AND METHODS. All patients who discontinued TDF between 2003 and 2015 were screened and included in the study if the reason for withdrawal was nephrotoxicity. Kidney function (eGFR, proteinuria, haematuria) was assessed on treatment and one year after discontinuation. Factors associated with not achieving eGFR recovery one year after discontinuing TDF were assessed. RESULTS. A total of 69 patients out of 1625 screened discontinued TDF due to nephrotoxicity and were included in the analysis. At the end of the study period eGFR (CKD-EPI) improved in 52 (75,4%) patients. The eGFR difference was 11,7 ml/min/1,73m2 (95% CI: 6,0 – 14,5). Two factors were associated with kidney function improvement: the length of TDF treatment and baseline eGFR. Better recovery was observed in patients treated with shorter (difference: 15,6 ml/min/1,73m2, 95% CI: 5,99 – 23,0) and in those with impaired renal function at baseline (difference: 21 ml/min/1,73m2, 95% CI: 11,0 – 27,99). CONCLUSIONS. In majority of patients who discontinue TDF therapy, kidney function improves during oneyear period. The drug withdrawal in case of eGFR deterioration should not be postponed.

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Factors associated with urinary tract infections among HIV-1 infected patients

Cited by 20 publications

References 31 publications

Bacteria urinary tract infection in HIV-infected children and adolescents in Abuja, Nigeria: a cross-sectional study

Bacteria urinary tract infection in HIV-infected children and adolescents in Abuja, Nigeria: a cross-sectional study

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

Discontinuation of tenofovir due to nephrotoxicity: insight into 12 years of clinical practice

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