*1Bale, M. I., 1Sinumvayo, J. P., 2Badmus, R. A., 3Babatunde, S. K., 4Aroyehun, A. B., and 1Adeyemo, R. O.
1Department of Microbiology and Parasitology, College of Medicine and Health Sciences, University of Rwanda, Republic of Rwanda
2Department of Microbiology Faculty of Pure and Applied Sciences, Kwara State University, Malete, Kwara State, Nigeria
3Department of Biological Sciences, Kola Daisi University, Ibadan, Nigeria
4Department of Clinical Nutrition, University of Aberdeen, King’s College, Aberdeen, AB24 3FX, Scotland
*Correspondence to: muribaale@gmail.com; i.muritala@ur.ac.rw
Abstract:
Background: Urinary tract infection (UTI) is one of the most common type of infections worldwide, and this is usually preceded by asymptomatic significant bacteriuria (ASB). The emergence of antibiotic resistance in bacteria responsible for UTI makes this entity of public challenge, which has been fueled by human immunodeficiency virus (HIV) infection. This study determined the prevalence of ASB and antimicrobial susceptibility pattern of bacteria isolated from urine samples of selected HIV-infected patients in Ilorin, Nigeria.
Methodology: A cross-sectional study of 300 randomly selected HIV-positive patients from Sobi Specialist and Civil Service hospitals in Ilorin, Kwara State, Nigeria, was conducted from January to March 2019. Clean-catch midstream urine samples were aseptically collected from each selected participant, cultured on CLED and Blood agar plates, and incubated aerobically at 37oC for 24 hours. The bacterial growth on the culture plates were identified using standard microbiological techniques. The Kirby-Bauer disk diffusion method was used to determine the antibiotic sensitivity of the bacterial isolates against a panel of antibiotics.
Results: The overall prevalence of ASB among the participants was 22.3%. Staphylococcus aureus (41.8%, 28/67), Escherichia coli (25.4%, 17/67), and Klebsiella pneumoniae (17.9%, 12/67) were the predominant bacterial isolates. Staphylococcus aureus was resistant to amoxicillin-clavulanate (64.3%), ceftriaxone (53.6%), ciprofloxacin (64.3%), and nalidixic acid (71.4%); E. coli was also resistant to amoxicillin-clavulanate (70.6%), ceftriaxone (53.6%), ciprofloxacin (52.9%) and nalidixic acid (64.7%); and K. pneumoniae was moderately resistant to amoxicillinclavulanate (50.0%) and resistant to ciprofloxacin (58.3%) and nalidixic acid (75.0%). Multidrug resistance (MDR) was observed in 40.8% of the isolates.
Conclusion: The isolation rate of high MDR bacteria highlights the growing challenge of ASB and UTIs that are becoming increasingly difficult to treat with available antibiotics. Health professionals should be aware of regional resistance pattern to consider in the current empirical antimicrobial therapy for ASB and UTIs among HIV-infected patients. Strategies to mitigate spread of resistance are urgently needed in the study area.
Keywords: antimicrobial resistance, asymptomatic significant bacteriuria, prevalence, HIV
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