title: Preponderance of bacterial isolates in urine of HIV-positive malaria-infected pregnant women with urinary tract infection.
abstract: BACKGROUND
  This study examined HIV and malaria co-infection as a risk factor for urinary tract infections (UTIs) in pregnancy. The study group included 74 pregnant women, 20 to 42 years of age, who attended the antenatal clinic at the Specialist Hospital at Akure, Ondo State, Nigeria.
  
  
  METHODS
  Forty-four of the pregnant women were either HIV seropositive with malaria infection (HIV+Mal+) or HIV seropositive without malaria (HIV+Mal-). The remaining thirty pregnant women served as controls and included women HIV seronegative but with malaria (HIV-Mal+) and women HIV seronegative without malaria. UTI was indicated by a bacterial colony count of greater than 10⁵/mL of urine, using cysteine lactose electrolyte deficient medium (CLED) as the primary isolation medium. Bacterial isolates were characterized using convectional bacteriological methods, and antibiotics sensitivity tests were carried out using the disk diffusion method.
  
  
  RESULTS
  A total of 246 bacterial isolates were recovered from the cultures, with a mean of 3.53 isolates per subject. Women who were HIV+Mal+ had the most diverse group of bacterial isolates and the highest frequency of UTIs. The bacterial isolates from the HIV+Mal+ women also showed the highest degree of antibiotic resistance.
  
  
  CONCLUSIONS
  While pregnancy and HIV infection may each represent a risk factor for UTI, HIV and malaria co-infection may increase its frequency in pregnancy. The higher frequency of multiple antibiotic resistance observed among the isolates, particularly isolates from HIV+Mal+ subjects, poses a serious public health concern as these strains may aggravate the prognosis of both UTI and HIV infection.
authors.affiliation: Faculty of Science, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria. kwashajibad@yahoo.com.
authors.forename: Kwashie Ajibade
authors.initials: KA
authors.lastname: Ako-Nai
authors.forename: Blessing Itohan
authors.initials: BI
authors.lastname: Ebhodaghe
authors.forename: Patrick
authors.initials: P
authors.lastname: Osho
authors.forename: Ebun
authors.initials: E
authors.lastname: Adejuyigbe
authors.forename: Folasade Mubiat
authors.initials: FM
authors.lastname: Adeyemi
authors.forename: Olakunle O
authors.initials: OO
authors.lastname: Kassim
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D001431:Bacteriological Techniques; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008288:Malaria / Q000150:complications*; D009549:Nigeria; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000382:microbiology; D018570:Risk Assessment; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D014556:Urine
chemical_list: D000900:Anti-Bacterial Agents