Factors associated with urinary tract infections among HIV-1 infected patients

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. Clinic...

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Published in:PloS one 2018-01, Vol.13 (1), p.e0190564-e0190564
Main Authors: Skrzat-Klapaczyńska, Agata, Matłosz, Bartłomiej, Bednarska, Agnieszka, Paciorek, Marcin, Firląg-Burkacka, Ewa, Horban, Andrzej, Kowalska, Justyna D
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adult
AIDS
Analysis
Bacteria
Bacterial infections
Biology and Life Sciences
CD4 antigen
Cell culture
Diabetes
Drug resistance
Drug therapy
E coli
Epidemiology
Female
Females
Health aspects
Health risk assessment
Hepatitis
HIV
HIV Infections - complications
HIV patients
HIV-1
Hospitals
Human immunodeficiency virus
Humans
Identification
Infections
Infectious diseases
Lymphocytes
Male
Males
Mathematical models
Median (statistics)
Medical prognosis
Medicine and Health Sciences
Mens health
Microorganisms
Pathogens
Patients
People and Places
Population
Population (statistical)
Regression analysis
Regression models
Ribonucleic acid
Risk factors
RNA
Statistical analysis
Urinary tract
Urinary tract diseases
Urinary tract infections
Urinary Tract Infections - complications
Urine
Urogenital system
Viruses
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cited_by cdi_FETCH-LOGICAL-c692t-bce4a59a0019125647e8556fd0cd5ac798b788dd0d6bfdd273fbd5553538b68a3
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creator Skrzat-Klapaczyńska, Agata
Matłosz, Bartłomiej
Bednarska, Agnieszka
Paciorek, Marcin
Firląg-Burkacka, Ewa
Horban, Andrzej
Kowalska, Justyna D
description 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. 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. 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
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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. 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. 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&lt;0.0001), infected through other than homosexual mode (80.1% vs. 50.7%, p&lt;0.0001), with lower nadir CD4 count (139 vs. 221 cells/μl, p&lt;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. We have identified that almost one third of patients had urinary tract infections with non-typical bacterial pathogens. 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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. 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. 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. 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Population with increased odds of urinary tract infections are women, patients infected through other than homosexual contacts and those registered before 2007.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Bacteria</subject><subject>Bacterial infections</subject><subject>Biology and Life Sciences</subject><subject>CD4 antigen</subject><subject>Cell culture</subject><subject>Diabetes</subject><subject>Drug resistance</subject><subject>Drug therapy</subject><subject>E coli</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Females</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Hepatitis</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV patients</subject><subject>HIV-1</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Identification</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Males</subject><subject>Mathematical models</subject><subject>Median (statistics)</subject><subject>Medical prognosis</subject><subject>Medicine and Health Sciences</subject><subject>Mens health</subject><subject>Microorganisms</subject><subject>Pathogens</subject><subject>Patients</subject><subject>People and Places</subject><subject>Population</subject><subject>Population (statistical)</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Ribonucleic acid</subject><subject>Risk factors</subject><subject>RNA</subject><subject>Statistical analysis</subject><subject>Urinary tract</subject><subject>Urinary tract diseases</subject><subject>Urinary tract infections</subject><subject>Urinary Tract Infections - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Skrzat-Klapaczyńska, Agata</au><au>Matłosz, Bartłomiej</au><au>Bednarska, Agnieszka</au><au>Paciorek, Marcin</au><au>Firląg-Burkacka, Ewa</au><au>Horban, Andrzej</au><au>Kowalska, Justyna D</au><au>Jombo, Godwin Terver</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors associated with urinary tract infections among HIV-1 infected patients</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-01-11</date><risdate>2018</risdate><volume>13</volume><issue>1</issue><spage>e0190564</spage><epage>e0190564</epage><pages>e0190564-e0190564</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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. 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. 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&lt;0.0001), infected through other than homosexual mode (80.1% vs. 50.7%, p&lt;0.0001), with lower nadir CD4 count (139 vs. 221 cells/μl, p&lt;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. 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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29324763</pmid><doi>10.1371/journal.pone.0190564</doi><tpages>e0190564</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
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subjects Acquired immune deficiency syndrome
Adult
AIDS
Analysis
Bacteria
Bacterial infections
Biology and Life Sciences
CD4 antigen
Cell culture
Diabetes
Drug resistance
Drug therapy
E coli
Epidemiology
Female
Females
Health aspects
Health risk assessment
Hepatitis
HIV
HIV Infections - complications
HIV patients
HIV-1
Hospitals
Human immunodeficiency virus
Humans
Identification
Infections
Infectious diseases
Lymphocytes
Male
Males
Mathematical models
Median (statistics)
Medical prognosis
Medicine and Health Sciences
Mens health
Microorganisms
Pathogens
Patients
People and Places
Population
Population (statistical)
Regression analysis
Regression models
Ribonucleic acid
Risk factors
RNA
Statistical analysis
Urinary tract
Urinary tract diseases
Urinary tract infections
Urinary Tract Infections - complications
Urine
Urogenital system
Viruses
title Factors associated with urinary tract infections among HIV-1 infected patients
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