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Urinary Tract Infections (UTIs)
in a cohort of HIV and Non-HIV-infected females in Port
Harcourt, Nigeria
Frank-Peterside N,
Okerentugba PO, Ndukwu J, Okonko IO
Medical Microbiology Unit,
Department of Microbiology, University of Port Harcourt, P.M.B.
5323, Choba, East-West Road, Port Harcourt, Rivers State,
Nigeria;
E-mail address:
iheanyi.okonko@uniport.edu.ng, Tel: +2348035380891
ABSTRACT:
UTI is the most common problem found in all age group patients.
UTI has more prevalence in HIV-infected patients because of
decreased immune status compared to Non-HIV infected
individuals. The aim of this study was to find the prevalence of
UTI
in a cohort of
HIV and Non-HIV-infected females and planning its treatment
strategy based on etiologic agent.
Clean catch midstream urine samples were collected from 100
female subjects comprising 50 HIV-seropositive and 50 HIV-seronegative
females in Port Harcourt, Nigeria. The HIV-positive females
consisted of 20 highly active retroviral therapy (HAART) – naïve
females and 30 subjects on HAART for three to six months. Most
of the HIV-positive females had no signs or symptoms of UTI
compared to HIV-negative females. Urine samples were analysed
using standard methods. Microbial isolates were identified in
urine and susceptibility tests were performed. The ages of the
subjects ranged from 25-50 years. Of
the 100 samples analysed, 37 had significant bacteriuria
representing 37.0%. Among the 50 HIV seropositive females,
17(34.0%) had significant bacteriuria while among the HIV
seronegative females (controls), 21 (42.0%) samples had
significant bacteria growth. Bacterial uropathogens were
significantly prevalent (42.0 vs. 34.0, P<0.05) among HIV
seronegative females (controls) than HIV seropositive females.
There was significant difference (40.0 vs. 25.0, P<0.05) in the
prevalence of significant bacteriuria between HIV seropositive
females on HAART and HAART naïve females. Generally,
Staphylococcus aureus 10(26.3%) was most predominant in the
urine samples. This was followed by Klebsiella species
7(18.4%), Escherichia coli 6(15.8%), Pseudomonas
aeruginosa 5(13.2%), Proteus species 3(7.9%),
Streptococcus species 3(7.9%), Enterococcus
faecalis 2(5.3%) and Staphylococcus epidermidis
2(5.3%). Among the HIV seropositive females, Escherichia coli
5(29.4%) was the most predominant while among the HIV
seronegative females, Staphylococcus aureus 6(28.6%) was
the most predominant. However, Staphylococcus epidermidis
was only present among the HIV seronegatives.
Also,
Candida albicans
10(71.4%) was most predominant fungi isolates. This was followed
by Aspergillus species 2(14.3%) and Penicillium
species 2(14.3%). However, Aspergillus species
2(33.3%) was only present among the HIV seronegatives.
High
sensitivity to ofloxacin (85.7%), ceprox (85.7%), ciprofloxacin
(78.9%), peflacine (76.2%), gentamicin (60.5%), lincocin
(58.8%), rifampicin (58.8%), streptomycin (55.3%), augmentin
(52.4%) and ampiclox (52.4%) was recorded. High resistance to
nalidixic acid (90.5%), septrin (80.9%), chloramphenicol
(70.6%), floxapen (64.7%), nrobactin (64.7%), erythromycin
(58.8%), ampicillin (57.1%), ampiclox (47.6%), augmentin
(47.6%), and septromycin (44.7%) were observed. In
conclusion, urinary tract infection is a significant
co-morbidity in females with HIV.
This study reveals a high prevalence of urinary tract infections
in a cohort of HIV seropositive females in Port Harcourt,
Nigeria.
Thus, a high
index of suspicion will lead to its prompt diagnosis and
appropriate treatment. Of particular importance is the
sensitivity patterns of the strains of bacteria isolated, in
which ofloxacin, ceprox, ciprofloxacin, peflacine and gentamicin
were the most effective. This calls for adequate
planning for UTI treatment strategy based on etiologic agent.
Prospective studies are advocated to clarify whether these
antibiotics confers some benefit in protecting HIV seropositive
individuals against UTI.
[Frank-Peterside
N, Okerentugba PO, Ndukwu J, Okonko IO.
Urinary Tract Infections (UTIs)
in a cohort of HIV and Non-HIV-infected females in Port
Harcourt, Nigeria]
Cancer Biology 2013;3(3):1-10]. (ISSN:
2150-1041).
http://www.cancerbio.net. 1
doi:10.7537/marscbj030313.01
Keywords:
Antibiograms, Coinfections, Gram-positive bacteria,
Gram-negative bacteria, HIV, HAART |
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