Infection and Drug Resistance (Apr 2021)
Prevalence of Multidrug Resistant UTI Among People Living with HIV in Northern Tanzania
Abstract
Bartholomeo Nicholaus Ngowi,1 Bruno Sunguya,2 Ayesiga Herman,3 Alfred Chacha,4 Eusebious Maro,5 Leonard France Rugarabamu,1 John Bartlett,6 Emmanuel Balandya,2 Kien Alfred Mteta,1 Blandina Theophil Mmbaga6,7 1Urology Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 2School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es salaam, Tanzania; 3General Surgery Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 4Clinical Laboratory Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 5Obstetric and Gynecology Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 6Duke University, Durham, NC, USA; 7Kilimanjaro Clinical Research Institute, Moshi, TanzaniaCorrespondence: Bartholomeo Nicholaus NgowiKilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, TanzaniaTel +255 767175560Email [email protected]: Bacterial urinary tract infection (BUTI) is the commonest urinary tract infection among people living with human immunodeficiency virus (PLHIV). It causes significant morbidity in this vulnerable group. Immunosuppression due to HIV can mask the signs and symptoms of infection leading to asymptomatic disease. There is limited evidence in Tanzania regarding BUTI and PLHIV. This study aimed to determine the prevalence, etiology, risk factors and susceptibility pattern of isolates causing asymptomatic UTI in PLHIV at Kilimanjaro Christian Medical Centre (KCMC).Patients and Methods: This cross-sectional study was conducted from July to September 2020 at Kilimanjaro Christian Medical Centre (KCMC) hospital. A questionnaire was used to collect social demographic data from patients’ files together with necessary information required by this study. Urine samples were obtained from participants for urinalysis and urine culture and sensitivity. Data from 300 adults aged ≥ 18 years were analyzed using Statistical Package for Social Science (SPSS) version 22. Mean or median with their measure of dispersion were calculated for continuous variables. Logistic regression was used to determine associations between variables, where P-value < 0.05 was considered to be significant.Results: Bacteriuria was prevalent in 37 (12.3%) of PLHIV. Positive nitrite in urine was associated with bacteriuria (P = 0.01). Gram-positive bacteria were the most common 25 (67.6%) isolates with high sensitivity to nitrofurantoin (88.2%) followed by gentamycin (69.2%). However, resistance was high against ciprofloxacin (77.8%). Multidrug resistance (MDR) was noted in 17 (45.9%).Conclusion: One in eight of PLHIV attending CTC at KCMC referral hospital in Northern zone of Tanzania have BUTI. Presence of nitrites in urine is an important biomarker associated with BUTI. About two third of the isolates were Gram-positive bacteria, and nearly half of all isolates showed MDR to commonly used antibiotics.Keywords: bacteriuria, bacteria urinary tract infection, people living with human immunodeficiency virus, multidrug resistance, Tanzania
