Objectives: There is limited published data concerning the recent epidemiology
of urinary tract infections (UTI) in HIV-patients, thus we analysed independent
risk factors for UTI in HIV positive individuals and antimicrobial resistance
rates of E. coli to antimicrobial agents commonly used in UTI. To determine the
prevalence of symptomatic urinary tract infections (UTI) in HIV-patients, we performed
a retrospective case-control study.
Methods: We included 313 HIV-patients, 101 with UTI and 212 age and gendermatched
controls, attending the HIV outpatient clinic at the Vienna University
Hospital (VUH) over a period from January 2011 to September 2016. The patients’
specific data was gathered from the electronic database of the VUH. The statistical
analysis was performed using SPSS Software Version 20.0.
Results: HIV infected individuals with CD4 count >200 cells/mm3 were less likely
than HIV infected individuals with CD4 count <200 cells/mm3 to experience UTI
(OR 0.811, 95% CI 0.712-0.923 vs. OR 2.555, 95% CI 1.553 - 4.205, respectively).
The in vitro resistance rate of E. coli to antimicrobial agents was as follows: ciprofloxacin
(41%), mecillinam (20.5%), trimethoprim (61%), ampicillin (67%), ampicillin/
clavulanic acid (23%), cefuroxime (17%), nitrofurantoin (2%), amikacin (0%)
and gentamicin (9.5%).
Conclusion: Immunological status (CD4 count) is an important parameter for risk assessment
of UTIs in HIV-patients. The increased resistance rate of E. coli to commonly
used antimicrobial agents needs to be considered when it comes to the management
of UTI, additionally, surveillance strategies should be implemented in HIV-patients.