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Prevalence of Asymptomatic Bacteriuria in HIV Infected Patients in a Tertiary Hospital in Lagos, Nigeria

People living with Human Immunodeficiency Virus (HIV) are more predisposed to urinary tract infections due to suppression of their immunity by the virus. Asymptomatic bacteriuria is associated with an increased risk of symptomatic urinary tract infection and the latter being an important contributor to development of chronic renal failure, hypertension and toxaemia of pregnancy. In this study, the authors aimed to determine the prevalence of asymptomatic bacteriuria in HIV-infected patients and proffer a recommendation on the need or otherwise to screen. 

The authors conducted a cross-sectional study of treatment-naive HIV-infected patients attending the HIV clinics of Lagos State University Teaching Hospital (LASUTH), Ikeja. A total of 156 consenting participants were recruited into the study. The mean age was 36.45 ± 8.65 years old. And there were 60 of 156 (38.4%) males and 96 of 156 (61.56%) females. A single voided aseptically collected mid-stream urine (MSU) was obtained from each patient and all samples processed immediately were sent for urinalysis and culture. Isolates were considered significant if there were ≥105 colony forming unit/mL (CFU/mL) with 2 or less isolates, doubtful significance if <105 CFU/mL. Significant isolates were selected for identification. Data were analyzed by using SPSS version 16.0 (Statistical Package for Social Sciences, Inc., Chicago, Ill). 

The results showed that only 33 of 156 (21.2%) had significant bacteriuria, out of the 33 participants, 19 (57.8%) were asymptomatic, while 14 of 33 (42.4%) had significant growth but were symptomatic or on antibiotics. E. coli was isolated in 9 of 19 (47.3%), followed by Staph aureus 4 of 19 (21.05%). In addition, 18 of 19 patients (94.73%) who had asymptomatic bacteriuria in this study were females, this was keeping with previous studies which reported a much higher prevalence in females.

In conclusion, more than half of participants who had significant growth had asymptomatic bacteriuria, while one-fifth of all patients had significant growth. Considering this statistics, screening for or treatment of asymptomatic bacteriuria may be recommended in all HIV-infected patients.

Article by Akinsegun Akinbami, et al, from Nigeria.

Full access: http://mrw.so/1i0UBA
Image by Carmen Arismendy, from Flickr-cc.



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