Bacterial urinary tract infections and its relation with CD4⁺ T lymphocyte cell count among people living with HIV in Ajmer City, Center of Rajasthan.

Abstract

Acquired immunodeficiency syndrome (AIDS) is a global health problem which weakens the immune system and makes it vulnerable to secondary opportunistic infections such as urinary tract infections (UTIs). In case of impaired immunity, asymptomatic UTIs may progress into symptomatic infection or even to sepsis and death. The current study was performed to determine the occurrence of UTI among HIV positive patients and its co-relation with CD4⁺ count. Sociodemographic data along with CD4⁺ cell count data of people living with HIV presented with signs and symptoms of UTIs were collected. Midstream urine samples were collected and sent to microbiology for culture and sensitivity testing. Among the 101 participants, 79 had pathogen isolated from their urine specimens. <i>Pseudomonas species</i> was the most common isolate followed by CoNS, <i>S. aureus</i>, <i>E. coli</i>, Yeasts, <i>Streptococcus species</i>, and <i>Enterobacter species</i>. <i>Pseudomonas species</i> were found highly sensitive to Meropenem, Ampicillin-Sulbactan, Ciprofloxacin, and Norfloxacin. Nitrofurantoin was recorded as most effective antibiotic against both gram-positive as well as gram-negative bacteria (except <i>Pseudomonas species</i>). Among the 70 individuals having bacterial UTIs, 40 had CD4⁺ cell count <200 cells/mm³ followed by CD4⁺ cell count between 200 and 500 cells/mm³ in 22 individuals and only 08 person had CD4⁺ cell count >500 cells/mm³. Low CD4⁺ cell count acts as a risk factor for bacterial UTIs. <i>Pseudomonas species</i> becoming a common pathogen among people living with HIV which is intrinsically resistant to Nitrofurantoin, a broad spectrum antibiotic used commonly to treat UTIs.