URINARY TRACT INFECTION IN ADULT PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV) AT THE UNIVERSITY OF NIGERIA TEACHING HOSPITAL (UNTH), ENUGU.

Abstract

This descriptive cross-sectional study was carried out between June 2010 and November 2011, to determine the prevalence and resistance patterns of the bacterial agents of urinary tract infections (UTI) in adult patients with Human Immunodeficiency Virus (HIV) infections attending the Harvard- PEPFAR HIV clinic at the University of Nigeria Teaching Hospital (UNTH), Enugu. It involved 300 adult patients sero-positive for HIV based on the current national algorithm, aged between 15-49 years, with mean age of 22 years, matched for age and sex with another 300 healthy subjects as controls. There was significant bacteriuria in 17 (5.7%) of the 300 mid-stream (MSU) sample of urine. Most patients (67.0%-76.0%) with significant bacteriuria were asymptomatic. There was a preponderance of females 76% against 24% for males with significant bacteriuria. The prevalence of UTI in adult HIV patients at the UNTH was 5.7%. The urinary isolates were monomicrobial in 13 (82.0%) and poly-microbial in 4 (18.0%) of the 17 MSU with significant bacteriuria. Gram negative bacilli were the most predominant (95.0%) bacteria isolated. The most predominant urinary bacteria isolated was Escherichia coli (55.0%), closely followed by Klebsiella pneumoniae (25.0%), Proteus mirabilis (10.0%), Pseudomonas aeruginosa (5.0%) and Staphylococcus saprophyticus (5.0%). All the organisms isolated generally showed high antibiotic susceptibility rates to meropenem(100%), ceftazidime(100%), ofloxacin (90%), ciprofloxacin(82%)and ceftriaxone(60%). Most of the organisms isolated were resistant to the common antibiotics such as cotrimoxazole(78.8%), nitrofurantoin(84.0%) and amoxicillin-clavulanic acid(80.0%). Twenty percent of the Klebsiella pneumoniae isolated produced extended spectrum beta-lactamase (ESBL).

URINARY TRACT INFECTION IN ADULT PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV) AT THE UNIVERSITY OF NIGERIA TEACHING HOSPITAL (UNTH), ENUGU.