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Kahsay T, Gebrehiwot GT, Gebreyohannes G, Tilahun M, Gessese A, Kahsay A. Antimicrobial susceptibility patterns of urinary tract infections causing bacterial isolates and associated risk factors among HIV patients in Tigray, Northern Ethiopia. BMC Microbiol 2024; 24:148. [PMID: 38678188 PMCID: PMC11055276 DOI: 10.1186/s12866-024-03297-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/07/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Urinary tract infections, a prevalent global infectious disease, are clinical issues not well studied in HIV-positive individuals. UTIs have become a global drug resistance issue, but the prevalence and antibiotic susceptibility patterns of UTI-causing bacteria among HIV patients in Tigray, Ethiopia, are poorly understood. This study aims to identify the prevalence of UTI-causing bacteria, their antibiotic susceptibility patterns, and associated risk factors in HIV patients attending ART clinics at Mekelle General Hospital and Ayder Comprehensive Specialized Hospital in Tigray, Northern Ethiopia. METHOD Clean-catch midstream urine samples (10-15 mL) were collected from HIV patients who are attending ART clinics at Mekelle General Hospital and Ayder Comprehensive Specialized Hospital. Samples were analyzed based on standard microbiological protocols using cysteine-lactose electrolyte deficient (CLED) agar. Pure colonies of bacterial isolates were obtained by sub-culturing into Mac-Conkey, Manitol Salt agar and blood agar plates. The bacterial isolates were then identified using macroscopic, microscopic, biochemical, and Gram staining methods. Gram-negative bacteria were identified using biochemical tests like triple sugar iron agar, Simon's citrate agar, lysine iron agar, urea, motility test, and indol test, whereas Gram-positive isolates were identified using catalase and coagulase tests. The Kirby-Bauer disk diffusion technique was used to analyze the antimicrobial susceptibility pattern of bacterial isolates. Data was analyzed using SPSS version 25.0. RESULTS Among the 224 patients, 28 (12.5%) of them had been infected by UTIs-causing bacteria. E. coli was the dominant bacterium (16 (57%)) followed by K. pneumoniae (4 (14%)), and S. aureus (3 (11%)). Of the total bacterial isolates, 22 (78.6%) of them developed multi-drug resistance. All Gram-positive (100%) and 75% of Gram-negative bacterial isolates were found to be resistant to two or more drugs. Patients with a history of UTIs, and with CD4 count < 200 cells/ mm3, were more likely to have significant bacteriuria. Compared to male patients, female patients were more affected by the UTIs-causing bacteria. More than 93% of the UTIs-causing bacterial isolates were susceptible to nitrofurantoin, ceftriaxone, ciprofloxacin, and gentamycin; whereas they are highly resistant to ampicillin (96%), cotrimoxazole (82%) and tetracycline (71%). CONCLUSIONS Most of the bacterial isolates were highly resistant to ampicillin, cotrimoxazole, and tetracycline. Female patients were more affected by the UTIs causing bacteria. The highest prevalence (12.5%) of UTIs in HIV patients needs special attention for better management and monitoring. Previous UTI history and immune suppression are predictors of UTIs, highlighting the need for intervention measures involving molecular studies to identify resistant bacteria genes and promote patient immune reconstitution.
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Affiliation(s)
- Tsgabu Kahsay
- Department of Microbiology and Immunology, Dr. Tewelde Legesse College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - Gebrecherkos Teame Gebrehiwot
- Department of Biomedical Research and Technology Transfer, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia.
| | - Gebreselema Gebreyohannes
- Department of Biomedical Research and Technology Transfer, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
- Department of Biological and Chemical Engineering, Mekelle Institute Technology, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Mulugeta Tilahun
- Department of Biomedical Research and Technology Transfer, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
| | - Ataklti Gessese
- Department of Biomedical Research and Technology Transfer, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
| | - Amlisha Kahsay
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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Khatoon I, Khanam S, Azam A, Qadeer S, Naz S, Hassan NU. Incidence Pattern, Antibiotic Susceptibility Pattern and Associated Risk Factors of Bacterial Uropathogens Among General Population of Pakistan. Infect Drug Resist 2023; 16:4995-5005. [PMID: 37551281 PMCID: PMC10404436 DOI: 10.2147/idr.s418045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/21/2023] [Indexed: 08/09/2023] Open
Abstract
Purpose Urinary tract infections (UTIs) are of the most common bacterial infections in Pakistan. Rapid increase in antibiotic resistance has resulted in a limited number of treatment options available. This study aimed to determine the incidence patterns of uropathogens, their antimicrobial susceptibility pattern and risk factors for UTI among the general population. Methods This laboratory-based cross-sectional study was conducted between November 2020 and March 2021. Urine samples were collected, cultured and bacterial isolates were identified. Bacterial isolates were tested for antimicrobial susceptibility. Data regarding socio-demographic characteristics, clinical features and risk factors were collected using structured questionnaire. Results Of 459 urine samples, 299 (65.1%) showed positive urine cultures (105 CFU/mL). Both gram-negative and gram-positive isolates were obtained, with a prevalence of 230 (76.9%) and 69 (23%), respectively. Escherichia coli was the predominant bacteria isolated 146 (48.8%), and it showed most susceptibility to cefoperazone and imipenem. Most of the gram-negative isolates were resistant towards ampicillin. Most risk factors were not significantly associated with UTI, except for age, income, and previous history of hospitalization. Conclusion UTI is an important problem in the study area, with a prevalence rate of 65%. All bacterial isolates developed resistance towards most antibiotics available on the market. Therefore, there is a need to develop management strategies based on susceptibility pattern of uropathogens. Additionally, proper public education regarding causes of disease transmission and control strategies is required.
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Affiliation(s)
- Iram Khatoon
- Department of Zoology, Women University Swabi, Swabi, Khyber Pakhtunkhwa, Pakistan
| | - Surrya Khanam
- Department of Zoology, Women University Swabi, Swabi, Khyber Pakhtunkhwa, Pakistan
| | - Asima Azam
- Department of Zoology, Shaheed Benazir Bhutto Women University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Saima Qadeer
- Department of Zoology, Division of Science & Technology, University of Education Lahore, Lahore, Punjab, 54000, Pakistan
| | - Shumaila Naz
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Punjab, Pakistan
| | - Najm Ul Hassan
- Department of Microbiology, Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa, Pakistan
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Simeneh E, Gezimu T, Woldemariam M, Alelign D. Magnitude of Multidrug-resistant Bacterial Uropathogens and Associated Factors in Urinary Tract Infection Suspected Adult HIV-Positive Patients in Southern Ethiopia. Open Microbiol J 2022. [DOI: 10.2174/18742858-v16-e2208180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Due to the reduction of their immunity, people living with the human immunodeficiency virus (HIV) are more susceptible to acquiring urinary tract infections (UTI). Moreover, the emergence of drug-resistant bacterial uropathogens has grown widely and now constitutes a severe clinical problem among HIV-positive patients.
Methods:
An institution-based cross-sectional study was conducted at the ART clinic of Arba Minch General Hospital from 1st January to 30th May, 2021. A total of 251 adult HIV-positive patients clinically suspected of having UTIs were systematically recruited. Socio-demographic and other factors were collected by a pre-tested structured questionnaire. A clean-catch mid-stream urine sample was collected and inoculated onto blood agar, MacConkey agar, and cysteine lactose electrolyte deficient agar (CLED). The inoculated culture media were incubated aerobically at 37°C for 24 hrs. After overnight incubation, significant bacteriuria, 105 CFU/ml, was considered. Bacterial identification was made by standard protocols. Antimicrobial susceptibility testing was done by Kirby Bauer’s disk diffusion method. The data was analyzed using SPSS version 25. A P-value less than 0.05 was used as statistical significance.
Results:
The overall magnitude of multidrug-resistant (MDR) uropathogens was found to be 14.3%, with a 95% CI (10-19.1). Gram-negative bacteria (83.3%) were the predominant MDR isolates, with E. coli (41.7%) followed by K. pneumoniae (22.2%). All isolates of S. aureus and two-thirds of the isolated CoNS were MDR. A total of 30% and 16.7% of Gram-negative isolates were ESBL and carbapenemase producers, respectively, whereas 50% and 33.3% of isolated S. aureus and CoNS were methicillin-resistant, respectively. Antibiotic use in the previous 6 months [AOR = 6.7, 95% CI: (2.53-17.6)], presence of chronic underlying disease [AOR = 7.03, 95% CI: (1.72-28.73)], antibiotic use without a prescription [AOR = 9.7, 95% CI: (3.53-26.675)], CD4+ counts less than 250 cells/mm3 [AOR = 8.05, 95% CI: (2.078–31.154)], and CD4+ count in between 250-500 cells/mm3 [AOR = 2.49, 95% CI: (1.05-5.923)] were found to be statistically significant associated with MDR uropathogens.
Conclusion:
This study found a significant number of multidrug-resistant uropathogens, indicating that healthcare providers should be aware of this and take urgent action to minimize resistance spread, as well as consider current empirical antibiotic therapy for UTI in HIV-positive patients.
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Abdullahi IN, Issaoui R, Usman Y. Prevalence and genetic lineages of Staphylococcus aureus nasal colonization and urinary tract infection among people living with HIV/AIDS in Nigeria: A systematic review. IJID REGIONS 2022; 4:17-24. [PMID: 36093365 PMCID: PMC9453218 DOI: 10.1016/j.ijregi.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/14/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
To provide an empirical insight on Staphylococcus aureus (S. aureus) nasal colonization and urinary tract infection (UTI) among people living with HIV/AIDS (PLWHA) in Nigeria, a quantitative synthesis and systematic review were executed. A comprehensive bibliometric search was conducted for published articles using the keywords 'nasal S. aureus carriage', 'Urinary S. aureus', 'nasal MRSA', 'staphylococci-HIV coinfection', 'urinary MRSA' and 'all states of Nigeria'. Eligible studies and the number of subjects (n) were analysed according to the PRISMA criteria. Out of the 79 examined studies, only 6 (n=1181) and 6 (n= 1350) on nasal and urine samples, respectively, were eligible. The pooled prevalence of nasal carriage and UTI of S. aureus were 29.6% and 6.8%, respectively. However, the pooled nasal MRSA carriage was 13.4%. The pooled prevalence of luk-F/S-PV-carrying S. aureus among nasal samples was 13.0%. Molecular typing from 3 studies showed MRSA-ST8-t064 and MSSA-ST15-t084 as the predominant genetic lineages. The S. aureus isolates from both sample types had the highest (>50%) resistance to penicillin, sulfamethoxazole-trimethoprim, erythromycin, and tetracycline. Multi-drug resistance was not significantly higher among S. aureus isolates from urine than nasal samples (60% versus 40.0% of eligible studies) (p= 0.5271). A moderate and high pooled prevalence of genetically diverse MRSA and luk-F/S-PV-carrying S. aureus were obtained from PLWHA, respectively. These findings emphasize the importance of routine screening for MRSA among PLWHA in Nigeria and other HIV endemic countries.
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Affiliation(s)
- Idris Nasir Abdullahi
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, College of Medical Sciences, Ahmadu Bello University, PMB 05 Zaria, Nigeria
| | - Rabeb Issaoui
- Department of Biology, University of Tunis El-Manar, Tunis, Tunisia
| | - Yahaya Usman
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, College of Medical Sciences, Ahmadu Bello University, PMB 05 Zaria, Nigeria
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Bhargava K, Nath G, Bhargava A, Kumari R, Aseri GK, Jain N. Bacterial profile and antibiotic susceptibility pattern of uropathogens causing urinary tract infection in the eastern part of Northern India. Front Microbiol 2022; 13:965053. [PMID: 36016776 PMCID: PMC9396120 DOI: 10.3389/fmicb.2022.965053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/15/2022] [Indexed: 11/27/2022] Open
Abstract
Urinary tract infection (UTI) is a common infectious disease that affects men and women. It is a significant health concern due to multidrug-resistant (MDR) organisms. Therefore, it is necessary to have a current understanding of the antibiotic susceptibility (AS) pattern of uropathogens to manage UTI effectively. Since the bacterial pathogen causing UTI and its AS vary with time and place, the prevailing AS pattern of the causative agents are essential for empirical antibiotic therapy. This study aims to determine the prevalence and AS of uropathogens isolated from UTI patients in the eastern part of Northern India. The study was carried out between November 2018 and December 2019. Clean catch midstream urine samples were collected and processed using standard guidelines for microbiological procedures. Positive microbiological cultures were found in 333 of the 427 patients, where 287 were gram-negative bacteria (GNB), and 46 were gram-positive bacteria (GPB). Females had a higher prevalence of UTI (60.7%) than males (39.3%) (p = 0.00024). The most susceptible age group in females was 18–50 years as compared to males, whereas at the age of 51–80 years and >80 years males were more susceptible than females (p = 0.053). The most prevalent pathogen identified were Escherichia coli (55.0%), followed by Proteus sp. (6.9%), Klebsiella pneumoniae (6.6%), Pseudomonas aeruginosa (6.3%), of which 96.0% were MDR bacteria. The susceptibility pattern of our study also revealed that amikacin, gentamycin and imipenem were the most effective drugs against GNB. In contrast, nitrofurantoin, vancomycin, and chloramphenicol were the most effective drugs against GPB. According tothe findings, MDR pathogens are very much prevalent. Since UTI is one of the most frequent bacterial diseases, proper management necessitates extensive investigation and implementation of antibiotic policy based on AS patterns for a particular region.
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Affiliation(s)
- Kanika Bhargava
- Amity Institute of Microbial Technology, Amity University Rajasthan, Jaipur, India
- Department of Microbiology, Institute of Medical Sciences (IMS), Banaras Hindu University, Varanasi, India
| | - Gopal Nath
- Department of Microbiology, Institute of Medical Sciences (IMS), Banaras Hindu University, Varanasi, India
- Gopal Nath,
| | - Amit Bhargava
- Department of Medicine, Hayes Memorial Hospital, Sam Higginbottom University of Agriculture, Technology and Sciences (SHUATS), Allahabad, India
| | - Ritu Kumari
- Department of Microbiology, Institute of Medical Sciences (IMS), Banaras Hindu University, Varanasi, India
| | - G. K. Aseri
- Amity Institute of Microbial Technology, Amity University Rajasthan, Jaipur, India
| | - Neelam Jain
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
- *Correspondence: Neelam Jain,
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Ngowi BN, Sunguya B, Herman A, Chacha A, Maro E, Rugarabamu LF, Bartlett J, Balandya E, Mteta KA, Mmbaga BT. Prevalence of Multidrug Resistant UTI Among People Living with HIV in Northern Tanzania. Infect Drug Resist 2021; 14:1623-1633. [PMID: 33911886 PMCID: PMC8075732 DOI: 10.2147/idr.s299776] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/11/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Bacterial urinary tract infection (BUTI) is the commonest urinary tract infection among people living with human immunodeficiency virus (PLHIV). It causes significant morbidity in this vulnerable group. Immunosuppression due to HIV can mask the signs and symptoms of infection leading to asymptomatic disease. There is limited evidence in Tanzania regarding BUTI and PLHIV. This study aimed to determine the prevalence, etiology, risk factors and susceptibility pattern of isolates causing asymptomatic UTI in PLHIV at Kilimanjaro Christian Medical Centre (KCMC). PATIENTS AND METHODS This cross-sectional study was conducted from July to September 2020 at Kilimanjaro Christian Medical Centre (KCMC) hospital. A questionnaire was used to collect social demographic data from patients' files together with necessary information required by this study. Urine samples were obtained from participants for urinalysis and urine culture and sensitivity. Data from 300 adults aged ≥18 years were analyzed using Statistical Package for Social Science (SPSS) version 22. Mean or median with their measure of dispersion were calculated for continuous variables. Logistic regression was used to determine associations between variables, where P-value <0.05 was considered to be significant. RESULTS Bacteriuria was prevalent in 37 (12.3%) of PLHIV. Positive nitrite in urine was associated with bacteriuria (P = 0.01). Gram-positive bacteria were the most common 25 (67.6%) isolates with high sensitivity to nitrofurantoin (88.2%) followed by gentamycin (69.2%). However, resistance was high against ciprofloxacin (77.8%). Multidrug resistance (MDR) was noted in 17 (45.9%). CONCLUSION One in eight of PLHIV attending CTC at KCMC referral hospital in Northern zone of Tanzania have BUTI. Presence of nitrites in urine is an important biomarker associated with BUTI. About two third of the isolates were Gram-positive bacteria, and nearly half of all isolates showed MDR to commonly used antibiotics.
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Affiliation(s)
| | - Bruno Sunguya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es salaam, Tanzania
| | - Ayesiga Herman
- General Surgery Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Alfred Chacha
- Clinical Laboratory Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Eusebious Maro
- Obstetric and Gynecology Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | | | | - Emmanuel Balandya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es salaam, Tanzania
| | - Kien Alfred Mteta
- Urology Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Haile Hantalo A, Haile Taassaw K, Solomon Bisetegen F, Woldeamanuel Mulate Y. 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. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:799-808. [PMID: 33273865 PMCID: PMC7708265 DOI: 10.2147/hiv.s244619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 10/29/2020] [Indexed: 11/30/2022]
Abstract
Background Urinary tract infection remains one of the major public health problems in developing countries, including Ethiopia. Its prevalence is fuelled by human immunodeficiency virus infection which represents a considerable health problem amongst these populations. This study aimed to assess the prevalence, antimicrobial susceptibility pattern and associated factors of bacterial urinary tract infections among adult PLHIV. Methods Cross-sectional study was conducted from May to December, 2018 among adult people living with HIV/AIDS in Wolaita Sodo University Teaching and Referral Hospital. The socio-demographic data and clinical data were collected using structured questionnaire. Mid-stream urine sample was collected for bacterial isolation and identification. Antimicrobial sensitivity testing was done by Kirby-Bauer disk diffusion technique. Logistic regression was conducted to check the association between UTI and associated factors. Results The overall prevalence of urinary tract infection was 29 (14.1%). The predominant bacteria isolated was E. coli 13 (44.8%) followed by S. aureus 5 (17.2%). Gender, CD4 count, history of catheterization, history of hospitalization, and DM status were independent factors for the occurrence of urinary tract infection. E. coli species were 100% and 84.6% susceptible to ciprofloxacin and norfloxacin, respectively; whereas, there was a complete resistance to amoxicillin-clavulanic acid and ampicillin. K. pneumoniae was pan resistant to gentamicin, amikacin and ampicillin, whereas 100% sensitive to nitrofurantoin. The rate of MDR was 23 (79.3%) with the majority, 16 (69.6%), gram negative and seven (30.4%) gram positive. Conclusion The burden of UTI among people living with HIV was considerably high. The findings of this study will help policy makers and other stakeholders as baseline information.
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Affiliation(s)
- Admasu Haile Hantalo
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Kassahun Haile Taassaw
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Fithamlak Solomon Bisetegen
- Department of Medical Laboratory Sciences, College of Health Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Tessema NN, Ali MM, Zenebe MH. Bacterial associated urinary tract infection, risk factors, and drug susceptibility profile among adult people living with HIV at Haswassa University Comprehensive Specialized Hospital, Hawassa, Southern Esthiopia. Sci Rep 2020; 10:10790. [PMID: 32612139 PMCID: PMC7330024 DOI: 10.1038/s41598-020-67840-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/10/2020] [Indexed: 11/09/2022] Open
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.
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Affiliation(s)
| | - Musa Mohammed Ali
- School of Medical Laboratory Science, Hawassa University College of Medicine and Health Sciences, Awassa, Ethiopia.
| | - Mengistu Hyilemeriam Zenebe
- School of Medical Laboratory Science, Hawassa University College of Medicine and Health Sciences, Awassa, Ethiopia
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Odoki M, Almustapha Aliero A, Tibyangye J, Nyabayo Maniga J, Wampande E, Drago Kato C, Agwu E, Bazira J. Prevalence of Bacterial Urinary Tract Infections and Associated Factors among Patients Attending Hospitals in Bushenyi District, Uganda. Int J Microbiol 2019; 2019:4246780. [PMID: 30906323 PMCID: PMC6397969 DOI: 10.1155/2019/4246780] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/08/2019] [Accepted: 01/22/2019] [Indexed: 11/23/2022] Open
Abstract
Urinary tract infections (UTIs) are one of the major causes of morbidity and comorbidities in patients with underlying conditions, and it accounts for the majority of the reasons for hospital visit globally. Sound knowledge of factors associated with UTI may allow timely intervention that can easily bring the disease under control. This study was designed to determine the prevalence of UTI by isolating and characterizing the different bacterial etiological agents and to evaluate the factors associated with UTI. In this cross-sectional study, a total of 267, clean catch midstream urine (MSU) samples were collected aseptically and analyzed using standard microbiology methods. Data for the factors associated with UTI were obtained by use of questionnaires and standard laboratory tests for selected underlying conditions. The study revealed 86/267 (32.2%) UTI prevalence among patients attending hospitals in Bushenyi District, Uganda. Escherichia coli was the most prevalent bacterial uropathogen with 36/86 (41.9%) followed by Staphylococcus aureus 27/86 (31.4%), Klebsiella pneumoniae 10/86 (11.6%), Klebsiella oxytoca 6/86 (7.0%), Proteus mirabilis 3/86 (3.5%), Enterococcus faecalis 3/86 (3.5%), and Proteus vulgaris 1/86 (1.2%). This study has demonstrated that age ≤19 years, female gender, married individuals, genitourinary tract abnormalities, diabetes, hospitalization, indwelling catheter <6 days, and indwelling catheter >6 days had statistically significant relationships (p < 0.05) with UTI. Screening for UTI in hospitalized patients, female gender, married individuals, genitourinary tract abnormalities, indwelling catheter, and diabetics should be adopted.
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Affiliation(s)
- Martin Odoki
- Department of Microbiology and Immunology, Faculty of Biomedical Sciences, Kampala International University Western Campus, P.O. Box 71, Bushenyi, Kampala, Uganda
| | - Adamu Almustapha Aliero
- Department of Microbiology and Immunology, Faculty of Biomedical Sciences, Kampala International University Western Campus, P.O. Box 71, Bushenyi, Kampala, Uganda
| | - Julius Tibyangye
- Department of Microbiology and Immunology, Faculty of Biomedical Sciences, Kampala International University Western Campus, P.O. Box 71, Bushenyi, Kampala, Uganda
- Department of Microbiology and Immunology, College of Health, Medicine and Life Sciences, St. Augustine International University, P.O. Box 88, Kampala, Uganda
| | - Josephat Nyabayo Maniga
- Department of Microbiology and Immunology, Faculty of Biomedical Sciences, Kampala International University Western Campus, P.O. Box 71, Bushenyi, Kampala, Uganda
| | - Eddie Wampande
- Department of Biochemistry, Faculty of Biomedical Sciences, Kampala International University Western Campus, P.O. Box 71, Bushenyi, Kampala, Uganda
- Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Charles Drago Kato
- Department of Microbiology and Immunology, Faculty of Biomedical Sciences, Kampala International University Western Campus, P.O. Box 71, Bushenyi, Kampala, Uganda
- School of Bio-security, Biotechnical and Laboratory Sciences, College of Veterinary Medicine, Animal Resources and Bio-security, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Ezera Agwu
- Department of Microbiology and Immunology, Faculty of Biomedical Sciences, Kampala International University Western Campus, P.O. Box 71, Bushenyi, Kampala, Uganda
| | - Joel Bazira
- Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
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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. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2019; 2019:6780354. [PMID: 30881531 PMCID: PMC6381576 DOI: 10.1155/2019/6780354] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/10/2019] [Accepted: 01/17/2019] [Indexed: 12/02/2022]
Abstract
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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Skrzat-Klapaczyńska A, Matłosz B, Bednarska A, Paciorek M, Firląg-Burkacka E, Horban A, Kowalska JD. Factors associated with urinary tract infections among HIV-1 infected patients. PLoS One 2018; 13:e0190564. [PMID: 29324763 PMCID: PMC5764262 DOI: 10.1371/journal.pone.0190564] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 12/18/2017] [Indexed: 01/11/2023] Open
Abstract
Background Urinary tract infections remain an important yet underinvestigated clinical problem among HIV infected patients. Here we analyze factors associated with its occurrence and the spectrum of bacterial pathogens identified in the group of patients followed at the HIV Out-Patient Clinic in Warsaw. Methods Clinic database collected all medical information on patients routinely followed since 1994 to 2015. All patients with available urine culture were included into analyses, only the first culture was included. In statistical analyses logistic regression models were used to identify factors associated with positive culture. Results In total 608 patients had urine culture performed, 176 (28.9%) were females and 432 (71,1%) were males, 378 (62.2%) registered in care before/in 2007, 258 (42.4%) infected through homosexual contact. Median baseline lymphocyte CD4+ count was 385 (IQR:204–565) cells/μl and median nadir lymphocyte CD4+ count 197 (86–306) cells/μl. One hundred and eighteen patients were actively infected with HCV, as defined by positive real-time PCR. In total 141 (23.2%) patients had positive urine culture, the most common bacterial pathogen was E.coli (58.2%) and E. faecalis (12.8%). Patients with urinary tract infection were more likely to be female (51.8% vs. 22.1%, p<0.0001), infected through other than homosexual mode (80.1% vs. 50.7%, p<0.0001), with lower nadir CD4 count (139 vs. 221 cells/μl, p<0.0001) and lower baseline HIV RNA (4.02 vs. 4.35 log copies/ml, p = 0.01) and less likely to be HCV RNA positive (26.9% vs. 49.2%, p = 0.01). In multivariate regression model being registered before/in 2007 (OR = 2.10; [95%CI: 1.24–3.56]), infected through other than homosexual mode (2.05;[1.18–3.56]) and female gender (2.14;[1.33–3.44]) were increasing and higher nadir CD4+ count decreasing (0.92;[0.85–0.99]) the odds of urinary tract infection. Conclusions We have identified that almost one third of patients had urinary tract infections with non-typical bacterial pathogens. Population with increased odds of urinary tract infections are women, patients infected through other than homosexual contacts and those registered before 2007.
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Affiliation(s)
- Agata Skrzat-Klapaczyńska
- Medical University of Warsaw, Department for Adult's Infectious Diseases, Warsaw, Poland
- Hospital for Infectious Diseases, HIV Out-Patient Clinic, Warsaw, Poland
- * E-mail:
| | - Bartłomiej Matłosz
- Hospital for Infectious Diseases, HIV Out-Patient Clinic, Warsaw, Poland
| | - Agnieszka Bednarska
- Medical University of Warsaw, Department for Adult's Infectious Diseases, Warsaw, Poland
- Hospital for Infectious Diseases, HIV Out-Patient Clinic, Warsaw, Poland
| | - Marcin Paciorek
- Medical University of Warsaw, Department for Adult's Infectious Diseases, Warsaw, Poland
- Hospital for Infectious Diseases, HIV Out-Patient Clinic, Warsaw, Poland
| | | | - Andrzej Horban
- Medical University of Warsaw, Department for Adult's Infectious Diseases, Warsaw, Poland
- Hospital for Infectious Diseases, HIV Out-Patient Clinic, Warsaw, Poland
| | - Justyna D. Kowalska
- Medical University of Warsaw, Department for Adult's Infectious Diseases, Warsaw, Poland
- Hospital for Infectious Diseases, HIV Out-Patient Clinic, Warsaw, Poland
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