Urinary infections due to multi-drug-resistant Escherichia coli among persons with HIV disease at a tertiary AIDS care centre in South India.
BACKGROUND
While the spectrum of opportunistic infections due to HIV infection has been widely discussed, there are very limited data available in south India on certain incident infections especially urinary tract infections (UTI) in HIV-infected subjects.


METHODS
Bacterial aetiology of 350 symptomatic UTI in HIV-infected subjects and the drug resistance pattern of the Escherichia coli isolates tested between June 2005 and July 2007 at the YRG Centre for AIDS Research and Education, a tertiary HIV Referral Centre in Chennai has been described here.


RESULTS
E. coli was the most common etiological agent of UTI in HIV patients, followed by Staphylococcus aureus, Klebsiella pneumoniae, Enterococcus faecalis, Pseudomonas aeruginosa, Proteus spp. and Staphylococcus epidermidis. Twenty-nine E. coli isolates were multi-drug-resistant and 83.3% of the isolates were resistant to sulfamethoxazole-trimethoprim.


CONCLUSIONS
Urinary pathogens in HIV-infected patients demonstrate high antimicrobial resistance and with majority of therapy for UTIs being empiric, constant updates of the aetiological agents and their drug susceptibility pattern would largely be beneficial to clinicians in choosing the right drug.
Vignesh
Ramachandran
R
YRG Centre for AIDS Research and Education, VHS Campus, Rajiv Gandhi Salai, Taramani, Chennai, India.
Shankar
Esaki Muthu
EM
Murugavel
Kailapuri G
KG
Kumarasamy
Nagalingeswaran
N
Sekar
Ramalingam
R
Irene
Paulas
P
Solomon
Suniti
S
Balakrishnan
Pachamuthu
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D008875:Middle Aged; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
D000892:Anti-Infective Agents, Urinary; D015662:Trimethoprim, Sulfamethoxazole Drug Combination