Dataset Information

Prevalence of ESBL-producing Escherichia coli in adults with and without HIV presenting with urinary tract infections to primary care clinics in Zimbabwe.

ABSTRACT:

Background

People living with HIV may be at increased risk for infections with resistant organisms. Infections with ESBL-producing organisms are of particular concern because they limit treatment options for severe Gram-negative infections in low-resource settings.

Objectives

To investigate the association between HIV status and urinary tract infections (UTIs) with ESBL-producing Escherichia coli.

Patients and methods

Cross-sectional study enrolling adults presenting with UTI symptoms to primary care clinics in Harare, Zimbabwe. Demographic and clinical data were collected during interviews and a urine sample was collected for culture from each participant. Antimicrobial susceptibility testing was performed according to EUCAST recommendations.

Results

Of the 1164 who were enrolled into the study, 783 (64%) were female and 387 (33%) were HIV infected. The median age was 35.8 years. Urine cultures were positive in 338 (29.0%) participants, and the majority of bacterial isolates were E. coli (n = 254, 75.2%). The presence of ESBL was confirmed in 49/254 (19.3%) E. coli. Participants with HIV had a 2.13 (95% CI 1.05-4.32) higher odds of infection with ESBL-producing E. coli than individuals without HIV. Also, the prevalence of resistance to most antimicrobials was higher among participants with HIV.

Conclusions

This study found an association between HIV and ESBL-producing E. coli in patients presenting with symptoms suggestive of UTI to primary care in Harare. HIV status should be considered when prescribing empirical antimicrobial treatment.

SUBMITTER: Olaru ID

PROVIDER: S-EPMC8242135 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Publications

Prevalence of ESBL-producing <i>Escherichia coli</i> in adults with and without HIV presenting with urinary tract infections to primary care clinics in Zimbabwe.

Olaru Ioana D ID Ferrand Rashida A RA Chisenga Mutsawashe M Yeung Shunmay S Macrae Bruce B Chonzi Prosper P Stabler Richard A RA Hopkins Heidi H Mabey David D Masunda Kudzai P E KPE Kranzer Katharina K

JAC-antimicrobial resistance 20210630 2

<h4>Background</h4>People living with HIV may be at increased risk for infections with resistant organisms. Infections with ESBL-producing organisms are of particular concern because they limit treatment options for severe Gram-negative infections in low-resource settings.<h4>Objectives</h4>To investigate the association between HIV status and urinary tract infections (UTIs) with ESBL-producing <i>Escherichia coli</i>.<h4>Patients and methods</h4>Cross-sectional study enrolling adults presenting ...[more]

PMID: 34223141

Similar Datasets

Project description:BackgroundOral treatment alternatives for febrile urinary tract infections are limited in the era of increasing antimicrobial resistance. We aim to evaluate if the combination of pivmecillinam and amoxicillin/clavulanic acid is non-inferior to current alternatives for step-down therapy in adult patients with febrile urinary tract infection.MethodsWe plan to perform an investigator-initiated non-inferiority trial. Adult hospitalised patients treated with 1-5 days of intravenous antibiotics for acute febrile urinary tract infection caused by extended spectrum beta-lactamase (ESBL) producing Enterobacterales will be randomised 1:1 to either control (7-10 days of either oral ciprofloxacin 500 mg twice daily or oral trimethoprim-sulfamethoxazole 800 mg/160 mg twice daily or intravenous ertapenem 1 g once daily, depending on sex, drug allergy, glomerular filtration rate and susceptibility testing) or intervention (10 days of pivmecillinam 400 mg three times daily and amoxicillin/clavulanic acid 500/125 mg three times daily). The primary outcome will be clinical cure 10 days (+/- 2 days) after antibiotic treatment completion. Clinical cure is defined as being alive with absence of fever and return to non-infected baseline of urinary tract symptoms without additional antibiotic treatment or re-hospitalisation (for urinary tract infection) based on a centralised allocation-blinded structured telephone interview. We plan to recruit 330 patients to achieve 90% power based on a sample size simulation analysis using a two-group comparison, one-sided alpha of 2.5%, an absolute non-inferiority margin of 10% and expecting 93% clinical cure rate and 10% loss to follow-up. The primary endpoint will be analysed using generalised estimated equations and reported as risk difference for both intention-to-treat and per protocol populations. Patients are planned to be recruited from at least 10 centres in Sweden from 2023 to 2026.DiscussionIf the combination of pivmecillinam and amoxicillin/clavulanic acid is found to be non-inferior to the control drugs there are potential benefits in terms of tolerability, frequency of interactions, outpatient treatment, side effects, nosocomial infections and drive for further antimicrobial resistance compared to existing drugs.Trial registrationNCT05224401. Registered on February 4, 2022.

Dataset Information

Prevalence of ESBL-producing Escherichia coli in adults with and without HIV presenting with urinary tract infections to primary care clinics in Zimbabwe.

Background

Objectives

Patients and methods

Results

Conclusions

Publications

Prevalence of ESBL-producing <i>Escherichia coli</i> in adults with and without HIV presenting with urinary tract infections to primary care clinics in Zimbabwe.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Prevalence of ESBL-producing Escherichia coli in adults with and without HIV presenting with urinary tract infections to primary care clinics in Zimbabwe.

Background

Objectives

Patients and methods

Results

Conclusions

Publications

Prevalence of ESBL-producing &lt;i&gt;Escherichia coli&lt;/i&gt; in adults with and without HIV presenting with urinary tract infections to primary care clinics in Zimbabwe.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Prevalence of ESBL-producing <i>Escherichia coli</i> in adults with and without HIV presenting with urinary tract infections to primary care clinics in Zimbabwe.