Resistance of Uropathogens in Asymptomatic Urinary Tract Infection Among HIV-Infected Persons in the Niger Delta of Nigeria.
Worldwide the surveillance of antimicrobial resistance among urinary tract pathogens is useful to determine the important trend and geographical variation of uropathogens. The study evaluated the pathogen frequency, resistance rate and pattern among HIV-infected Nigerians. Midstream urine samples taken for culture from 187 consecutively recruited HIV- infected persons visiting the University of Port Harcourt from September 2004 to March 2006 were analyzed for antibiotic susceptibility and resistance. Positive cultures were defined as 105 cfu/ml of a single uropathogen. Susceptibility test was performed with disc diffusion test. Clinically significant pathogens were present in 25 (13.4%) of patients. Escherichia coli accounted for a significant number of isolates (40%). The majority of isolates were from women and immunocompromised patients with low CD +~ count (17.4% and 224 cells/ l) compared to males 4 and immunocompetent host (5.6% and 353 cells/ l respectively). Resistance was highest with Cotrimoxazole (100%) and Tetracycline (88%) followed by Nalidixic acid (44%) and Gentamycin (28%). Antimicrobial susceptibility was highest with Ofloxacin (Tarivid) (76%) followed by Nitrofurantoin (64%) and least with Tetracycline (4%) and Cotrimoxazole, which showed no susceptibility to any of the isolate. This study indicates a widespread resistance of uropathogens to commonly prescribed antibiotics. There is an urgent need for the development of a policy on antibiotic use in Nigeria to optimize therapeutic benefits and reduce treatment cost. There is also the need for the re-intensification of public enlightenment campaign of the entire Niger Delta on the danger of drug resistant uropathrogens, antibiotic abuse and non-compliance to treatment.