Bacteriuria and Antimicrobial Susceptibility Pattern Among HIV Patients Attending ALERT Center, Addis Ababa, Ethiopia

Urinary tract infections are some of the most common bacterial diseases both in general population and amongst HIV infected patients. It is important to define the prevalence and drug susceptibility pattern of bacteriuria among HIV patients in Ethiopia and especially in Addis Ababa, because of the information scarcity about bacteriuria in HIV patients in our region. A cross sectional study was conducted in ALERT Center; Addis Ababa, Ethiopia; from 2014 to 2015 among 165 adult HIV patients. Midstream urine was collected with sterile wide-mouthed urine cups. Samples were inoculated to Cysteine lactose electrolyte deficient, Blood agar and MacConkey accordingly and biochemical tests performed to identify the isolates. Drug susceptibility pattern of isolates were determined using the disk diffusion techniques. Data analyzed using SPSS version-20 software package. Chi-square test was used to see the association between the outcome variable and independent and the strength of the association was identified using odds ratio in the binary logistic regression. Female study participants showed at least three times more likely to have bacteriuria (AOR=3.25, 95% CI= 0.98-10.79) than the male. Subsequent multivariate analysis CD4 value less than 200 cells/mm3 (p=0.02) retained its significance association. Presence of dysuria was almost three times (AOR=2.87; 95% CI=0.84-9.79) and previous history of UTI at least two times (AOR=2.38; 95%=0.73-7.72) more likely to have bacteriuria than absence of them. The isolated bacteria were E. coli (38.5%), followed by S. aureus (30.8%), P. mirabilis (11.5%), S. epidermidis (11.5%) and S. saprophyticus (7.7%). Bacterial isolates in the current study were most sensitive to ceftriaxone (100%), nitrofurantoin (88.46%), gentamicin (84.62%) and ceftazidime (84.62%) while resistant to ampicillin (84.62%), tetracycline (92.31%) and trimethoprim-sulfamethoxazole (88.46%). The occurrence of bacteriuria and susceptibility pattern of the antibiotics in the current study was comparable to other studies in HIV patients. The identified bacteria were reported by other authors as UTI causative agents in HIV patients. Still, bacteriuria in HIV patients needs more consideration for better management and preventing drug resistance.