Preponderance of bacterial isolates in urine of HIV-positive malaria-infected pregnant women with urinary tract infection
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Date
2014
Journal Title
Journal ISSN
Volume Title
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Abstract
Original Article
Preponderance of bacterial isolates in urine of HIV-positive malaria-infected
pregnant women with urinary tract infection
Kwashie Ajibade Ako-Nai1, Blessing Itohan Ebhodaghe1, Patrick Osho2, Ebun Adejuyigbe3, Folasade
Mubiat Adeyemi4, Olakunle O Kassim5
1 Department of Microbiology, Faculty of Science, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
2 HIV Programme, Department of Haematology, State Specialist Hospital Akure, Ondo State, Nigeria
3 Department of Paediatrics and Child Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife,
Osun State, Nigeria
4 Department of Biological Sciences, Faculty of Basic and Applied Sciences, College of Science, Engineering and
Technology, Osun State University, Osogbo, Nigeria
5 Department of Microbiology, Howard University College of Medicine, Washington DC, United States
Abstract
Introduction: This study examined HIV and malaria co-infection as a risk factor for urinary tract infections (UTIs) in pregnancy. The study
group included 74 pregnant women, 20 to 42 years of age, who attended the antenatal clinic at the Specialist Hospital at Akure, Ondo State,
Nigeria.
Methodology: Forty-four of the pregnant women were either HIV seropositive with malaria infection (HIV+Mal+) or HIV seropositive
without malaria (HIV+Mal-). The remaining thirty pregnant women served as controls and included women HIV seronegative but with
malaria (HIV-Mal+) and women HIV seronegative without malaria. UTI was indicated by a bacterial colony count of greater than 105/mL of
urine, using cysteine lactose electrolyte deficient medium (CLED) as the primary isolation medium. Bacterial isolates were characterized
using convectional bacteriological methods, and antibiotics sensitivity tests were carried out using the disk diffusion method.
Results: A total of 246 bacterial isolates were recovered from the cultures, with a mean of 3.53 isolates per subject. Women who were
HIV+Mal+ had the most diverse group of bacterial isolates and the highest frequency of UTIs. The bacterial isolates from the HIV+Mal+
women also showed the highest degree of antibiotic resistance.
Conclusions: While pregnancy and HIV infection may each represent a risk factor for UTI, HIV and malaria co-infection may increase its
frequency in pregnancy. The higher frequency of multiple antibiotic resistance observed among the isolates, particularly isolates from
HIV+Mal+ subjects, poses a serious public health concern as these strains may aggravate the prognosis of both UTI and HIV infection
Description
The Journal of Infection in Developing Countries;1600pages
Keywords
HIV, malaria, ; antibiotic, Plasmodium, falciparum
Citation
... Apart from anatomy, a woman's propensity to develop UTIs has also been explained on the basis of other certain behavioural factors, including delays in micturition, sexual activity and the use of diaphragm and spermicidal agents (both of which promote colonization of periurethral area with coliform bacteria)[26]. Although sexually active young women are disproportionately affected, several other populations at increased risk of UTI include infants, pregnant women, the elderly, and other patients with sundry health conditions such as diabetes[14][15][16]21,22,[27][28][29][30][31][32][33], multiple sclerosis, rheumatoid arthritis[14][15][16]21,34]AIDS/HIV, HIV-Malaria co-infection[14][15][16][17]21,31], underlying urologic anatomical abnormalities (e.g. narrowing of the urethra or ureters), genitorurinary instrumentation[14][15][16]21,[32][33][34][35][36], spinal cord injuries[36,37], urine retention, vesicoureteral reflux[38][39][40][41][42], enlarged prostate (may inhibit urine flow in men)[43,44], kidney stones/kidney disease[16,45], Kidney transplant/allograft rejection[32,46,47], sickle cell disease and any condition that suppresses the immune system including Vitamin D deficiency[3,4,29,44,48]. ... ... Apart from anatomy, a woman's propensity to develop UTIs has also been explained on the basis of other certain behavioural factors, including delays in micturition, sexual activity and the use of diaphragm and spermicidal agents (both of which promote colonization of periurethral area with coliform bacteria)[26]. Although sexually active young women are disproportionately affected, several other populations at increased risk of UTI include infants, pregnant women, the elderly, and other patients with sundry health conditions such as diabetes[14][15][16]21,22,[27][28][29][30][31][32][33], multiple sclerosis, rheumatoid arthritis[14][15][16]21,34]AIDS/HIV, HIV-Malaria co-infection[14][15][16][17]21,31], underlying urologic anatomical abnormalities (e.g. narrowing of the urethra or ureters), genitorurinary instrumentation[14][15][16]21,[32][33][34][35][36], spinal cord injuries[36,37], urine retention, vesicoureteral reflux[38][39][40][41][42], enlarged prostate (may inhibit urine flow in men)[43,44], kidney stones/kidney disease[16,45], Kidney transplant/allograft rejection[32,46,47], sickle cell disease and any condition that suppresses the immune system including Vitamin D deficiency[3,4,29,44,48]. ...