Asymptomatic bacteriuria in human immunodeficiency (HIV)-infected women.
Objective: To determine the prevalence of bacteriuria in HIV- infected women versus healthy non-HIV-infected controls.Methods: A prospective cohort study was undertaken between January 1996 and March 1997. One hundred nineteen ambulatory, premenopausal women from the Women's HIV Clinic and 191 similar non-infected Gynecology Clinic controls were recruited. Information recorded from the medical record and patient questionnaire included: age, prior history of UTI, antibiotic usage, sexual frequency, diaphragm/spermicide use, and CD4 count. A clean catch urine culture was collected on all patients. Statistical analysis was via SPSSPC.Results: The mean age of HIV-infected women was 33 vs 26 for non-infected. The mean CD4 count was 341. A prior history of UTI (mean # per lifetime) was significantly higher for HIV women (2.8) vs controls (1.8) [P =.01]. The mean weekly sexual frequency was significantly higher in HIV-negative (2.1) vs HIV-infected (1.2) [P <.001]. Diaphragm/spermicidal use was uncommon but equal in both groups. The prevalence of any growth of uropathogens (>10(2) cfu/mL) was 30% in the HIV-infected vs 47% in controls. The percentage of asymptomatic bacteriuria for each range of uropathogen titer (cfu/mL) in urine was:Chronic antibiotic usage (39% of HIV-infected vs 4% of controls) was associated with a decreased prevalence of bacteriuria, but there was not a significant difference in prevalence of bacteriuria between groups. Regardless of titer ranges of uropathogens evaluated, the prevalence of bacteriuria was not different between CD4 counts of <200 and >/=200. As compared to controls, HIV-infected individuals demonstrated shifts toward nosocomial pathogens: Enterococcus, S. aureus and non-E. coli gram-negative rods.Conclusion: The prevalence of bacteriuria was not greater in HIV-infected women versus non-HIV-infected women versus HIV non-infected controls and was not significantly affected by antibiotic usage or CD4 count. Uropathogens responsible for asymptomatic bacteriuria in HIV-infected women are different from "healthy" controls and are more representative of nosocomial flora.
Gugino
L
Department of Gynecology and Obstetrics, University at Buffalo, New York, Buffalo, USA
Russo
T
Wactawski-Wende
J
Goodnough
SL
Tristram
DA
Mylotte
J