Prevalence of Asymptomatic Bacteriuria in HIV Positive Patients and The Antibiotic Susceptibility of The Bacterial Isolates

Abstract

Urinary tract infection remains a major public health problem in developing countries, where there are limited healthcare 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 cross sectional study was conducted during January-April/ 2023 to determine the prevalence, etiology and antimicrobial susceptibility pattern of isolates among HIV positive individuals compared to healthy controls. A total 180 mid-stream urine and blood samples were collected from 100 previously confirmed HIV positive patients attending Benghazi center for infectious diseases and immunology for their routine investigations, and 80 age and gender matched healthy subjects (control). The study consisted of 97 females, and males 83, with age ranging from 20 to 47. About 50 ml of clean– catch midstream urine was collected from each patient into sterile screw–capped universal container. The specimen was mixed, labeled and transported to the laboratory for processing. The bacterial species were identified by conventional laboratory methods according to the international standards. The results of the study revealed that, the prevalence evaluated by the number of organisms which showed significant growth on the culture among HIV positive subjects was 28%, while in the control group it was 35%, but no significant differences in the prevalence among both groups. No significant differences in the prevalence of UTI according to the age groups among both HIV positive subjects and control subjects. The prevalence of UTI was higher in females than males in general, with significant differences among HIV positive subjects, but with no significant differences among the control group. Totally 56 bacterial species were isolated from the subjects of the study, 67.9% were gram negative, 32.1% were gram positive. Among HIV positive subjects 21 (75%) were gram negative and 7 (25%) were gram positive, among the control group 17 (60.7%) were gram negative and 11 (39.3%) were gram negative, among the gram negative species, E. coli was the most predominant bacterial etiology among the study population (33.9%), followed by K. pneumonia it was (25%) equally in both groups, P. aeruginosa was (8.9%), which was more seen in HIV positive subjects than control. while among gram positive species, S. aureus was the most common pathogen (17.9%) equally found in both groups, S. agalactiae was (5.4%), more frequently in HIV subjects than control. S. saprophyticus was (3.6%), S. pyogenes was (4.5%) seen in the control group only with no significant differences in the distribution of the isolated species. The isolated uropathogens from HIV positive subjects were tested for their sensitivity to 12 antimicrobial agents, the results of antimicrobial susceptibility testing revealed that most species were resistant to more than three commonly used antimicrobial agents.