Vol. 6, Issue 2, Part B (2024)

Introduction: India is estimated to have around 1.16 lakhs annual new HIV infections among adults and around 14,500 new HIV infections among children in 2011. The main site of attack of HIV is the immune system, especially the CD4 T lymphocytes (CD4 cells). People living with HIV are likely to be more predisposed to UTI due to suppression of their immunity. UTI in HIV positive individuals can lead to life threatening diseases and thus accurate and prompt detection of the uropathogens from the urine specimens of HIV positive individuals is expedient to enhance the health status. Thus this study was undertaken to determine the occurrences of different microbes in the aetiology of urinary tract infections in HIV positive patients on ART.
Material and Methods: Total 250 urine specimens were collected from HIV positive cases of clinically diagnosed to have urinary tract infection presenting to the ART center at GMCH Nagpur. Samples were processed and isolates identified by standard techniques.
Results: Out of the 250 urine specimens, 132(52.8%) were from the female patients whereas 118(47.2%) were from male patients. Out of the 250 urine specimens from cases having UTI taking ART 200(80%) urine specimens showed significant growth (Colony count ≥100 CFU/ml). In 50 (20%) the growth was not significant.
E.coli was the commonest organism isolated from HIV positive patients with UTI on ART. This was followed by Klebsiella pnuemoniae 19.5%, Psuedomonas aeruginosa 13%, Citrobacter fruendii 5%, Acinetobacter baumannii 12.5% among the gram positive organisms, 12% Enterococcus faecalis, 2% Coagulase Negative Staphylococci (CoNS) and 4% Candida spp were isolated.
In the control group, Gram negative bacilli were the commonest cause of UTI. Gram positive cocci were found in 20% of the controls. E. coli was the commonest organism accounting for 35% followed by Klebsiella pnueminae accounting for 29%, Psuedomonas aeruginosa accounting for 16% and CoNS accounting for 20%.
Conclusion: In present study, HIV positive patients with low CD4 counts are infected with varied bacterial urinary pathogens compared with HIV seronegative with UTI. HIV positive patients with low CD4 counts were more frequently infected with bacterial urinary pathogens as compared to HIV positive patients with low CD4 counts.