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

Description

The data deposited was, the data used for the study aimed to address the lack of comprehensive data on urinary tract infections (UTIs) and antibacterial resistance among people living with human immunodeficiency virus (PLHIV) in low-income countries, specifically in central Ethiopia. It focused on investigating the prevalence of UTIs, identifying associated risk factors, determining the bacterial agents responsible for the infections, and analyzing the antibiotic susceptibility profiles of these bacteria. A hospital-based cross-sectional study was conducted to recruit 688 PLHIV by simple random sampling method. Background information were gathered through interviews while clinical information were gathered from recent information sheets of patient charts using organized, pretested, and validated study tool. Midstream urine was collected aseptically and transported to Microbiology Laboratory of Aklilu Lemma Institute of Pathobiology within four hours of collection maintaining its cold chain. Standard conventional microbial culture methods and matrix-assisted laser desorption ionization-time of flight mass spectrometry were used to identify the bacterial isolates at the species level. Kirby Bauer’s disc diffusion method was used to determine the antibiotic susceptibility profile of the bacterial isolates based on the interpretation guideline of Clinical Laboratory Standard Institute. Logistic regression was used to examine factors associated with the occurrence of UTIs with statistical significance level declared at P < 0.05. Out of 688 PLHIV involved in the current study, (n= 144; 20.9%) were positive for UTIs, where the majority were asymptomatic for UTIs. In the multivariable logistic regression analysis, only HIV RNA ≥ 200 copies/ml and being symptomatic for UTIs during the study period were found associated with the occurrence of UTIs. The dominant bacterial species isolated were E. coli (n= 65; 43%) followed by E. faecalis (n= 16; 10.6%), and K. pneumoniae (n= 11; 7.3%). Over half of the E. coli isolates were resistant to antibiotics like gentamicin (n= 44; 67.7%), amikacin (n= 46; 70.8%), nalidixic acid (n= 42; 64.6%), ciprofloxacin (n= 40; 61.5%), and azithromycin (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 S. aureus isolates were resistant to cefoxitin, which implies methicillin-resistant (MRSA). The high rate of UTIs and antibiotic resistance revealed in the current study, need public health interventions like educating the population about preventive measures, and importance of early treatment of UTIs. Our findings also highlight the need to provide UTIs screening service for PLHIV, and healthcare providers should adopt antibiotic stewardship programs to promote and ensure their appropriate and judicious use.

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Methods A hospital-based cross-sectional study was conducted to recruit 688 PLHIV by simple random sampling method. Background information were gathered through interviews while clinical information were gathered from recent information sheets of patient charts using organized, pretested, and validated study tool. Midstream urine was collected aseptically and transported to Microbiology Laboratory of Aklilu Lemma Institute of Pathobiology within four hours of collection maintaining its cold chain. Standard conventional microbial culture methods and matrix-assisted laser desorption ionization-time of flight mass spectrometry were used to identify the bacterial isolates at the species level. Kirby Bauer’s disc diffusion method was used to determine the antibiotic susceptibility profile of the bacterial isolates based on the interpretation guideline of Clinical Laboratory Standard Institute. Logistic regression was used to examine factors associated with the occurrence of UTIs with statistical significance level declared at P < 0.05.

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