Studies on Emergence of Drug Resistance in HIV Associated Bacterial Urinary Tract Infections

Abstract

Problem statement: This study was designed to document the prevalence of HIV associated urinary tract infections in Barshi Tahsil. Such studies had not been researched out before in this region. Approach: The study included samples from 123 HIV reactive and 40 HIV non-reactive patients. In both, mid stream samples were collected and processed to examine for bacterial opportunistic pathogens. The antibiogram of selected urinary isolates in HIV reactive as well as HIV non-reactive patients was studied by using disc diffusion technique and Kirby Bauer method. Study regarding molecular approach is in progress. Results: Urine samples from 75.46% of HIV reactive and 24.54% of HIV non reactive patients were culture positive. In all there were 74 urinary isolates from the HIV reactive cases. About (36.48%) were E. coli, (31.10%) were Pseudomonas aeruginosa and (24%) were Klebsiella. These urinary isolates were found in different age groups of both male and female but more number of isolates was found in female as compared to male. In addition, E. coli and Klebsiella were predominant in female and Pseudomonas aeruginosa was found predominant in male. The antibiogram of selected urinary isolates in HIV reactive as well as HIV non-reactive patients indicates that urinary isolates in HIV reactive patients were more drug resistant than HIV non-reactive patients. Conclusion: The isolation of urinary opportunistic pathogens among the HIV reactive patients was found to be significantly higher than in HIV nonreactive patients. Also the antibiogram of urinary opportunistic pathogens in HIV reactive patients was significant finding indicating severity of the infection in this group.

Detection of Extended-Spectrum &beta; Lactamases and AmpC &beta;-Lactamase Production in <i>Escherichia coli</i> Causing Urinary Tract Infection among HIV and Non-HIV Patients

“…As has been observed in a previous study, UTI is very common among both men and women with HIV disease (Pinho et al, 1994;Schonwald et al, 1999). The results of our study reveal that E. coli was the leading cause of UTI among hospitalized HIV patients and Non HIV antenatal patients which is in agreement with the previous reports (Deokar and Bodhankar, 2009;Pinho et al, 1994;Brenner and Rector, 1991;Wilkie et al, 1992).…”

Asymptomatic Bacteriuria in Hiv/Aids Patients: Occurrence and Risk Associated With Low Cd4 Counts.

“…All were sensitive to Tetracycline and Vancomycin. The antibiotic profile is similar to the studies of Deokar S.D et al, Iweriebor B.C and Ojoo J et al 2,20,21 . Prophylactic treatment of several opportunistic bacterial and parasitic infections using cotrimoxazole and penicillins has been ascribed to their increase resistance 9,11 .…”

“…A bacterial count of 1x10 4 / ml was considered significant for gram positive organisms. Antimicrobial susceptibility tests were performed using Kirby-Bauer disc diffusion method 5,2 . Urinalysis by chemical testing of urine was performed using SD Urocolor TM 10 test strips (urostrips) for Bilirubin, Urobilinogen, Nitrites, Specific gravity, protein, glucose, PH, erythrocyturia, leukocyturia and ketones according to manufacturer's instructions.…”

Drug-Resistant Bacterial Infections in HIV Patients

“…UTIs are one of the significant illnesses that cause clinical burden among HIV individuals. It is the most common nosocomial infection [7] and cause high rate of morbidity [18]. HIV disease is associated with a variety of renal syndromes in patients with low CD4+ cell counts, causing neurologic complications such as bladder areflexia and hyporeflexia, which lead to urinary stasis and ultimately infection [19,20].…”

“…First mechanism is direct viral killing of the infected cells; second is increased rate of apoptosis in infected cells; and third is killing of infected CD4+ cells by CD8 cytotoxic lymphocytes. Virus multiplication declines the number of CD4+ cells below a critical level; therefore, the cell mediated immunity is lost and the weaken immune system signal to various opportunistic infections (OIs) and cancers [6][7][8][9]. Compromised immune system of HIV patients increases the chances of acquiring various OIs caused by fungi, bacteria, parasites and other viruses based on the CD4 cell counts.…”