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      Detection of bacteriuria among human immunodeficiency virus seropositive individuals in Osogbo, south-western Nigeria

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          Abstract

          Human immunodeficiency virus-positive individuals are at increased risk of both asymptomatic and symptomatic urinary tract infections. The aim of this study was to determine the prevalence of asymptomatic bacteriuria (ASB) in HIV-positive individuals, its associated factors including any correlation with the CD4 count of the patient, and the antibiotic susceptibility pattern of the isolated organisms. Midstream urine and blood samples were collected from 242 consenting HIV-positive patients who were attending routine follow-up clinic during the six-month period of the study. Microscopy, culture, and antibiotic susceptibility testing of the samples were carried out following standard protocols, and CD4 counts were also determined. Fifty one (21.1%) of the 242 individuals had significant bacteriuria. The predominant organism was Klebsiella spp. (35%) followed by Escherichia coli (31%). Prevalence of bacteriuria was higher in the women. Low CD4 counts and young age were significantly associated with the presence of bacteriuria. ASB prevalence is high in this population and related to the CD4 count level.

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          Most cited references18

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          Asymptomatic bacteriuria - prevalence in the elderly population.

          To identify the prevalence of asymptomatic bacteriuria in the elderly population and to examine associated risk factors, complications and natural history, and whether treatment improves prognosis. A literature search of MEDLINE, PubMed and the Cochrane Library was undertaken of studies published from 1980 to 2009. A total of 70 articles were identified. Emphasis was given to randomised controlled trials, review articles and more recent publications. Asymptomatic bacteriuria is common in the elderly, especially among institutionalised or hospitalised patients. Risk factors include cognitive impairment, diabetes mellitus, structural urinary tract abnormalities and indwelling catheters. Antimicrobial therapy does not result in improved survival or genitourinary morbidity and may potentially cause avoidable side effects and the emergence of resistant organisms. Bacteriuria is common in functionally impaired elderly patients. In the absence of symptoms or signs of infection, routine dipstick screening and subsequent antimicrobial therapy is not recommended.
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            Prevalence and risk factors of asymptomatic bacteriuria among pregnant Nigerians infected with HIV.

            There are conflicting report on the association of HIV infection and asymptomatic bacteriuria (ASB). Most of these studies were from areas with low HIV burden. This study determined the prevalence and risk factors of ASB in HIV positive pregnant women.
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              Asymptomatic bacteriuria among diabetics attending Kenyatta National Hospital.

              Significant asymptomatic bacteriuria is an important cause of pyelonephritis and gram negative septicaemia among certain predisposed individuals, such as diabetics. We investigated the incidence of asymptomatic urinary tract infections (UTIs) among our diabetic patients and the type and antibacterial sensitivity patterns of the organisms causing these UTIs. One hundred and thirty five patients submitted midstream urine specimens for culture. Fifteen patients had positive cultures showing the incidence of asymptomatic UTI to be 11.1%. There were ten female and five male patients with UTI. The commonest organism isolated was Escherichia coli at 40%. Gram negative bacilli made up 66.7% of the isolates. Isolates were poorly sensitive to the regularly available antibiotics-ampicillin (33% sensitive, cotrimoxazole (33% sensitive). Nitrofurantoin inhibited growth in 93% of the isolates. Other antimicrobials with over 80% sensitivity level included: gentamicin, ceftazidime, augmentin, cefuroxime and norfloxacin. They are expensive or require parenteral administration. The incidence of asymptomatic UTI is high among diabetics and although the organisms isolated are those usually isolated in UTIs, they are not that sensitive to the commonly available and antibacterial agents.
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                Author and article information

                Journal
                1886
                122234
                European Journal of Microbiology and Immunology
                Akadémiai Kiadó
                2062-509X
                2062-8633
                1 March 2015
                26 March 2015
                : 5
                : 1 ( otherID: VRG7W6904000 )
                : 126-130
                Affiliations
                [ 1 ] Ladoke Akintola University of Technology Department of Medical Microbiology and Parasitology, College of Health Sciences P.M.B. 4400 LAUTECH Osogbo Osun State Nigeria
                [ 2 ] Ladoke Akintola University of Technology Teaching Hospital Department of Medical Microbiology and Parasitology Osogbo Nigeria
                [ 3 ] University College Hospital, U.C.H. Department of Medical Microbiology and Parasitology Ibadan Oyo State Nigeria
                [ 4 ] Ladoke Akintola University of Technology, LAUTECH Department of Haematology and Blood Transfusion, College of Health Sciences P.M.B. 4400 Osogbo Osun State Nigeria
                Article
                H231982L88275V83
                10.1556/eujmi-d-14-00036
                87e2cb3d-e5c6-4ac6-b7ca-0eb207bc2db1
                Categories
                Original Article

                Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
                Nigeria,antibacterial,CD4 count,bacteriuria in HIV

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