Bacterial urinary tract infections and its relation with CD4+ T lymphocyte cell count among people living with HIV in Ajmer City, Center of Rajasthan

Abstract

Introduction: Acquired immunodeficiency syndrome (AIDS) is a global health problem which weakens the immune system and makes it vulnerable to secondary opportunistic infections such as urinary tract infections (UTIs). In case of impaired immunity, asymptomatic UTIs may progress into symptomatic infection or even to sepsis and death. The current study was performed to determine the occurrence of UTI among HIV positive patients and its co-relation with CD4+ count. Materials and Methods: Sociodemographic data along with CD4+ cell count data of people living with HIV presented with signs and symptoms of UTIs were collected. Midstream urine samples were collected and sent to microbiology for culture and sensitivity testing. Result: Among the 101 participants, 79 had pathogen isolated from their urine specimens. Pseudomonas species was the most common isolate followed by CoNS, S. aureus, E. coli, Yeasts, Streptococcus species, and Enterobacter species. Pseudomonas species were found highly sensitive to Meropenem, Ampicillin-Sulbactan, Ciprofloxacin, and Norfloxacin. Nitrofurantoin was recorded as most effective antibiotic against both gram-positive as well as gram-negative bacteria (except Pseudomonas species). Among the 70 individuals having bacterial UTIs, 40 had CD4+ cell count 500 cells/mm3. Conclusion: Low CD4+ cell count acts as a risk factor for bacterial UTIs. Pseudomonas species becoming a common pathogen among people living with HIV which is intrinsically resistant to Nitrofurantoin, a broad spectrum antibiotic used commonly to treat UTIs.

Keywords

• aids
• empirical therapy
• human immunodeficiency virus
• nitrofurantoin