Inviting an author to review:
Find an author and click ‘Invite to review selected article’ near their name.
Search for authorsSearch for similar articles
25
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Urinary tract infection among people living with human immunodeficiency virus attending selected hospitals in Addis Ababa and Adama, central Ethiopia

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Urinary tract infections (UTIs) and antibacterial resistance (ABR) are important public health problems, but they are not well-studied among people living with human immunodeficiency virus (PLHIV) globally, especially in low-income countries. Therefore, it is important to regularly measure the extent of UTIs and ABR in the most susceptible populations. This study aimed to investigate the prevalence of UTIs, associated factors, bacterial causal agents, and their antibiotic susceptibility profile among PLHIV in central Ethiopia.

          Methods

          A hospital-based cross-sectional study was conducted to recruit 688 PLHIV by a simple random sampling method. Background information was gathered through interviews, while clinical information was gathered from recent information sheets of patient charts using organized, pretested, and validated study tools. Midstream urine was collected aseptically and transported to the Microbiology Laboratory of Aklilu Lemma Institute of Pathobiology within 4 h of collection, maintaining its cold chain. Standard conventional microbial culture methods and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry were used to identify the bacterial isolates at the species level. Kirby Bauer’s disk diffusion method was used to determine the antibiotic susceptibility profile of the bacterial isolates based on the interpretation guidelines of the Clinical Laboratory Standard Institute. Logistic regression models were used to examine factors associated with the occurrence of UTIs among PLHIV attending selected hospitals in Addis Ababa, and Adama.

          Results

          Out of 688 PLHIVs involved in the current study, 144 (20.9%) were positive for UTIs, whereas the majority were asymptomatic for UTIs. In the multivariable logistic regression analysis, only HIV RNA ≥ 200 copies/ml [AOR = 12.24 (95% CI, 3.24, 46.20), p < 0.01] and being symptomatic for UTIs during the study period [AOR = 11.57 (95% CI, 5.83, 22.97), p < 0.01] were associated with the occurrence of UTIs. The dominant bacterial species isolated were Escherichia coli ( E. coli; n = 65; 43%), followed by Enterococcus faecalis ( E. faecalis; n = 16; 10.6%) and Klebsiella pneumoniae ( K. pneumoniae; n = 11; 7.3%). Over half of the E. coli isolates were resistant to antibiotics such as gentamicin (GM; n = 44; 67.7%), amikacin (AN; n = 46; 70.8%), nalidixic acid (NA; n = 42; 64.6%), ciprofloxacin (CIP; n = 40; 61.5%), and azithromycin (AZM; n = 45; 69.2%). All of the K. pneumoniae isolates ( n = 11; 100%), ( n = 6; 54.5%), and ( n = 7; 63.6%) were resistant to [amoxicillin as well as amoxicillin + clavulanic acid], ceftriaxone, and sulfamethoxazole + trimethoprim, respectively. All the Staphylococcus aureus ( S. aureus) isolates were resistant to cefoxitin, which implies methicillin-resistant S. aureus (MRSA).

          Conclusion

          The high prevalence of UTIs and antibiotic resistance revealed in the current study needs public health interventions such as educating the population about preventive measures and the importance of early treatment of UTIs. Our findings also highlight the need to provide UTI screening services for PLHIV, and healthcare providers should adopt antibiotic stewardship programs to promote and ensure their appropriate and judicious use.

          Related collections

          Most cited references48

          • Record: found
          • Abstract: found
          • Article: not found

          Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance.

          Many different definitions for multidrug-resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant (PDR) bacteria are being used in the medical literature to characterize the different patterns of resistance found in healthcare-associated, antimicrobial-resistant bacteria. A group of international experts came together through a joint initiative by the European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC), to create a standardized international terminology with which to describe acquired resistance profiles in Staphylococcus aureus, Enterococcus spp., Enterobacteriaceae (other than Salmonella and Shigella), Pseudomonas aeruginosa and Acinetobacter spp., all bacteria often responsible for healthcare-associated infections and prone to multidrug resistance. Epidemiologically significant antimicrobial categories were constructed for each bacterium. Lists of antimicrobial categories proposed for antimicrobial susceptibility testing were created using documents and breakpoints from the Clinical Laboratory Standards Institute (CLSI), the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the United States Food and Drug Administration (FDA). MDR was defined as acquired non-susceptibility to at least one agent in three or more antimicrobial categories, XDR was defined as non-susceptibility to at least one agent in all but two or fewer antimicrobial categories (i.e. bacterial isolates remain susceptible to only one or two categories) and PDR was defined as non-susceptibility to all agents in all antimicrobial categories. To ensure correct application of these definitions, bacterial isolates should be tested against all or nearly all of the antimicrobial agents within the antimicrobial categories and selective reporting and suppression of results should be avoided. © 2011 European Society of Clinical Microbiology and Infectious Diseases. No claim to original US government works.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Urinary tract infections: epidemiology, mechanisms of infection and treatment options.

            Urinary tract infections (UTIs) are a severe public health problem and are caused by a range of pathogens, but most commonly by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus. High recurrence rates and increasing antimicrobial resistance among uropathogens threaten to greatly increase the economic burden of these infections. In this Review, we discuss how basic science studies are elucidating the molecular details of the crosstalk that occurs at the host-pathogen interface, as well as the consequences of these interactions for the pathophysiology of UTIs. We also describe current efforts to translate this knowledge into new clinical treatments for UTIs.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Global epidemiology of urinary tract infections.

              Both in the community and hospital setting, urinary tract infections (UTIs) are common. Initial appropriate empirical treatment requires a good knowledge of epidemiological data. In this review, the most recent global epidemiological data of UTIs have been summarized.
                Bookmark

                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/1888285/overviewRole: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/1775310/overviewRole: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/2692687/overviewRole: Role: Role: Role: Role:
                Role: Role: Role: Role:
                Role:
                URI : https://loop.frontiersin.org/people/149616/overviewRole:
                URI : https://loop.frontiersin.org/people/884689/overviewRole: Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/1203963/overviewRole: Role: Role: Role: Role: Role:
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                04 September 2024
                2024
                : 12
                : 1394842
                Affiliations
                [1] 1College of Health Sciences, Addis Ababa University , Addis Ababa, Ethiopia
                [2] 2Aklilu Lemma Institute of Pathobiology, Addis Ababa University , Addis Ababa, Ethiopia
                [3] 3Allied Health & Human Performance, University of South Australia , Adelaide, SA, Australia
                [4] 4Faculty of Medicine, Slovak Medical University , Bratislava, Slovakia
                [5] 5Ohio State University Global One Health , Addis Ababa, Ethiopia
                Author notes

                Edited by: Jens Andre Hammerl, Bundesinstitut für Risikobewertung, Germany

                Reviewed by: Norhan Khairy Abd El-Aziz, Zagazig University, Egypt

                Techalew Shimels Woldkiros, Hawassa University, Ethiopia

                *Correspondence: Ketema Bizuwork Gebremedhin, ketema.bizuwork@ 123456aau.edu.et
                Article
                10.3389/fpubh.2024.1394842
                11408745
                39296834
                939dd4c6-5375-496a-a027-db69660f9bc8
                Copyright © 2024 Gebremedhin, Yisma, Alemayehu, Medhin, Belay, Bopegamage, Amogne and Eguale.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 02 March 2024
                : 06 August 2024
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 65, Pages: 12, Words: 8742
                Funding
                Funded by: the Addis Ababa University
                The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study is supported by the Addis Ababa University Thematic Research Support Center with funding number RD/LT 025/2019.
                Categories
                Public Health
                Original Research
                Custom metadata
                Infectious Diseases: Epidemiology and Prevention

                human immunodeficiency virus (hiv),urinary tract infections (utis),antibacterial resistance,bacterial uropathogens,ethiopia

                Comments

                Comment on this article