Bacteriology and Antimicrobial Profile of Urinary Tract Infection in Adult Patients with Human Immunodeficiency Virus in a Nigerian Teaching Hospital

Abstract

Introduction: There has been a rising incidence of treatment failures of Urinary Tract Infection (UTI) in patients with human Immunodeficiency Virus Infection (HIV). This study was carried out to determine the bacteriology of urinary tract infections in patients with HIV infections in University of Nigeria Teaching Hospital, Enugu. Methods: The study was a cross sectional study, involving 300 adult HIV positive patients, matched for age and sex with apparently healthy HIV negative subjects as control. Mid-stream urine samples from both groups were cultured on MacConkey, blood agar plates and incubated aerobically at 37°C. Antimicrobial susceptibility testing was done with agar diffusion method and interpreted according to CSLI guidelines. Extended spectrum beta-lactamases production was confirmed phenotypically using double disc synergy test. Results: The mean age of the subjects was 22.0 ± 3 years. There was a preponderance of females 76.0%. (P=0.493). The prevalence of UTI in the study group was 5.7% as against 2.7% in the control group. The most predominant bacteria isolated from study group were Escherichia coli (55.0%) with the least being Staphyloccocus saprophyticus (5.0%). In the control group only Escherichia coli (62.5%) and Klebsiella pneumoniae (37.5%) were isolated (r=0.973, P=0.005). Most of the organisms isolated were resistant to the commonly used antibiotics. Twenty percent (20.0%) of the Klebsiella pneumoniae and 14.0% of Escherichia coli isolated were ESBL producing.