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Factors associated with urinary tract infections among HIV-1 infected patients
BACKGROUND: Urinary tract infections remain an important yet underinvestigated clinical problem among HIV infected patients. Here we analyze factors associated with its occurrence and the spectrum of bacterial pathogens identified in the group of patients followed at the HIV Out-Patient Clinic in Wa...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764262/ https://www.ncbi.nlm.nih.gov/pubmed/29324763 http://dx.doi.org/10.1371/journal.pone.0190564 |
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author | Skrzat-Klapaczyńska, Agata Matłosz, Bartłomiej Bednarska, Agnieszka Paciorek, Marcin Firląg-Burkacka, Ewa Horban, Andrzej Kowalska, Justyna D. |
author_facet | Skrzat-Klapaczyńska, Agata Matłosz, Bartłomiej Bednarska, Agnieszka Paciorek, Marcin Firląg-Burkacka, Ewa Horban, Andrzej Kowalska, Justyna D. |
author_sort | Skrzat-Klapaczyńska, Agata |
collection | PubMed |
description | BACKGROUND: Urinary tract infections remain an important yet underinvestigated clinical problem among HIV infected patients. Here we analyze factors associated with its occurrence and the spectrum of bacterial pathogens identified in the group of patients followed at the HIV Out-Patient Clinic in Warsaw. METHODS: Clinic database collected all medical information on patients routinely followed since 1994 to 2015. All patients with available urine culture were included into analyses, only the first culture was included. In statistical analyses logistic regression models were used to identify factors associated with positive culture. RESULTS: In total 608 patients had urine culture performed, 176 (28.9%) were females and 432 (71,1%) were males, 378 (62.2%) registered in care before/in 2007, 258 (42.4%) infected through homosexual contact. Median baseline lymphocyte CD4+ count was 385 (IQR:204–565) cells/μl and median nadir lymphocyte CD4+ count 197 (86–306) cells/μl. One hundred and eighteen patients were actively infected with HCV, as defined by positive real-time PCR. In total 141 (23.2%) patients had positive urine culture, the most common bacterial pathogen was E.coli (58.2%) and E. faecalis (12.8%). Patients with urinary tract infection were more likely to be female (51.8% vs. 22.1%, p<0.0001), infected through other than homosexual mode (80.1% vs. 50.7%, p<0.0001), with lower nadir CD4 count (139 vs. 221 cells/μl, p<0.0001) and lower baseline HIV RNA (4.02 vs. 4.35 log copies/ml, p = 0.01) and less likely to be HCV RNA positive (26.9% vs. 49.2%, p = 0.01). In multivariate regression model being registered before/in 2007 (OR = 2.10; [95%CI: 1.24–3.56]), infected through other than homosexual mode (2.05;[1.18–3.56]) and female gender (2.14;[1.33–3.44]) were increasing and higher nadir CD4+ count decreasing (0.92;[0.85–0.99]) the odds of urinary tract infection. CONCLUSIONS: We have identified that almost one third of patients had urinary tract infections with non-typical bacterial pathogens. Population with increased odds of urinary tract infections are women, patients infected through other than homosexual contacts and those registered before 2007. |
format | Online Article Text |
id | pubmed-5764262 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-57642622018-01-23 Factors associated with urinary tract infections among HIV-1 infected patients Skrzat-Klapaczyńska, Agata Matłosz, Bartłomiej Bednarska, Agnieszka Paciorek, Marcin Firląg-Burkacka, Ewa Horban, Andrzej Kowalska, Justyna D. PLoS One Research Article BACKGROUND: Urinary tract infections remain an important yet underinvestigated clinical problem among HIV infected patients. Here we analyze factors associated with its occurrence and the spectrum of bacterial pathogens identified in the group of patients followed at the HIV Out-Patient Clinic in Warsaw. METHODS: Clinic database collected all medical information on patients routinely followed since 1994 to 2015. All patients with available urine culture were included into analyses, only the first culture was included. In statistical analyses logistic regression models were used to identify factors associated with positive culture. RESULTS: In total 608 patients had urine culture performed, 176 (28.9%) were females and 432 (71,1%) were males, 378 (62.2%) registered in care before/in 2007, 258 (42.4%) infected through homosexual contact. Median baseline lymphocyte CD4+ count was 385 (IQR:204–565) cells/μl and median nadir lymphocyte CD4+ count 197 (86–306) cells/μl. One hundred and eighteen patients were actively infected with HCV, as defined by positive real-time PCR. In total 141 (23.2%) patients had positive urine culture, the most common bacterial pathogen was E.coli (58.2%) and E. faecalis (12.8%). Patients with urinary tract infection were more likely to be female (51.8% vs. 22.1%, p<0.0001), infected through other than homosexual mode (80.1% vs. 50.7%, p<0.0001), with lower nadir CD4 count (139 vs. 221 cells/μl, p<0.0001) and lower baseline HIV RNA (4.02 vs. 4.35 log copies/ml, p = 0.01) and less likely to be HCV RNA positive (26.9% vs. 49.2%, p = 0.01). In multivariate regression model being registered before/in 2007 (OR = 2.10; [95%CI: 1.24–3.56]), infected through other than homosexual mode (2.05;[1.18–3.56]) and female gender (2.14;[1.33–3.44]) were increasing and higher nadir CD4+ count decreasing (0.92;[0.85–0.99]) the odds of urinary tract infection. CONCLUSIONS: We have identified that almost one third of patients had urinary tract infections with non-typical bacterial pathogens. Population with increased odds of urinary tract infections are women, patients infected through other than homosexual contacts and those registered before 2007. Public Library of Science 2018-01-11 /pmc/articles/PMC5764262/ /pubmed/29324763 http://dx.doi.org/10.1371/journal.pone.0190564 Text en © 2018 Skrzat-Klapaczyńska et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Skrzat-Klapaczyńska, Agata Matłosz, Bartłomiej Bednarska, Agnieszka Paciorek, Marcin Firląg-Burkacka, Ewa Horban, Andrzej Kowalska, Justyna D. Factors associated with urinary tract infections among HIV-1 infected patients |
title | Factors associated with urinary tract infections among HIV-1 infected patients |
title_full | Factors associated with urinary tract infections among HIV-1 infected patients |
title_fullStr | Factors associated with urinary tract infections among HIV-1 infected patients |
title_full_unstemmed | Factors associated with urinary tract infections among HIV-1 infected patients |
title_short | Factors associated with urinary tract infections among HIV-1 infected patients |
title_sort | factors associated with urinary tract infections among hiv-1 infected patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764262/ https://www.ncbi.nlm.nih.gov/pubmed/29324763 http://dx.doi.org/10.1371/journal.pone.0190564 |
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