Preponderance of bacterial isolates in urine of HIV-positive malaria-infected pregnant women with urinary tract infection
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Date
2014
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Abstract
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. 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. 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. 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
journal Article;1600 pages,
Keywords
HIV, malaria, bacteria, antibiotic, co-infection
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]. ..