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.