Bacteriuria in a cohort of predominantly HIV-1 seropositive female commercial sex workers in Nairobi, Kenya
Identifieur interne : 000100 ( Istex/Corpus ); précédent : 000099; suivant : 000101Bacteriuria in a cohort of predominantly HIV-1 seropositive female commercial sex workers in Nairobi, Kenya
Auteurs : J. Ojoo ; J. Paul ; B. Batchelor ; M. Amir ; J. Kimari ; C. Mwachari ; J. Bwayo ; F. Plummer ; G. Gachihi ; P. Waiyaki ; C. GilksSource :
- Journal of Infection [ 0163-4453 ] ; 1996.
English descriptors
- KwdEn :
- Antimicrobial, Antimicrobial activity, Antimicrobial susceptibilities, Asymptomatic, Asymptomatic bacteriuria, Bacteriuria, Cell counts, Clinical manifestations, Clinical signs, Colony counts, Community clinic, Escherichia coli, Exact test, High rates, Higher rates, Immunocompetent women, Immunosuppression, Infection, Kenyan women, Lancet, Loin pain, Loin tenderness, Mycobacterial culture, Present study, Pyuria, Recent study, Seropositive, Sexual activity, Sexual intercourse, Significant association, Significant bacteriuria, Smelly urine, Study period, Susceptibility testing, Tract infection, Urinary, Urinary infection, Urinary tract, Urinary tract infection, Urinary tract infections, Urine, Urine culture, Urine samples.
- Teeft :
- Antimicrobial, Antimicrobial activity, Antimicrobial susceptibilities, Asymptomatic, Asymptomatic bacteriuria, Bacteriuria, Cell counts, Clinical manifestations, Clinical signs, Colony counts, Community clinic, Escherichia coli, Exact test, High rates, Higher rates, Immunocompetent women, Immunosuppression, Infection, Kenyan women, Lancet, Loin pain, Loin tenderness, Mycobacterial culture, Present study, Pyuria, Recent study, Seropositive, Sexual activity, Sexual intercourse, Significant association, Significant bacteriuria, Smelly urine, Study period, Susceptibility testing, Tract infection, Urinary, Urinary infection, Urinary tract, Urinary tract infection, Urinary tract infections, Urine, Urine culture, Urine samples.
Abstract
Although significant bacteriuria and urinary tract infection are more common in immunocompetent women than men, studies linking HIV immunosuppression with an increased risk of developing urinary infection have so far only been carried out in men. We therefore examined the relationship between bacteriuria and HIV status and CD4+cell count in a relatively homogenous cohort of female commercial sex workers (CSW) attending a community clinic in Nairobi. Two hundred and twenty-two women were enroled, and grouped according to HIV status and CD4 count. Group 1 were HIV seronegative (n = 52); Group 2 were HIV seropositive with CD4 + counts above 500 × 106/1 (n = 51); Group 3 were HIV seropositive with CD4 + counts between 201 and 500 × 106/1 (n = 67); Group 4 were HIV seropositive with CD4 + counts below 200 × 106/1 (n = 52). Clinical signs and symptoms were noted and mid-stream specimens of urine obtained for culture and sensitivity.Overall 23% (50/222) had significant bacteriuria. The rates in each group respectively were 25%, 29%, 19% and 23% and there was no significant association between bacteriuria and HIV status; or between bacteriuria and level of immunosuppression as indicated by CD4 + count. Overall 19% (30/222) of women had symptoms (frequency; dysuria; loin pain; smelly urine) or signs (fever; loin tenderness) compatible with urinary tract infection. However there was no significant association between symptoms or signs of infection and bacteriuria or HIV status. A typical range of pathogens, predominantly Enterobacteriaceae, were isolated and there were high rates of resistance to commonly used antimicrobials as well as 10% resistance to ciprofloxacin.Although high rates of significant bacteriuria can occur in highly sexually-active women, this appears unrelated to HIV infection or the level of HIV-related immunosuppression and is generally asymptomatic or clinically indistinct.
Url:
DOI: 10.1016/S0163-4453(96)92719-X
Links to Exploration step
ISTEX:290FA3DB06CDF3914ED0E57BD2DFECB144815DF8Le document en format XML
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Ojoo</name><affiliation><mods:affiliation>Kenya Medical Research Institute, Nairobi, Kenya</mods:affiliation></affiliation></author><author><name sortKey="Paul, J" sort="Paul, J" uniqKey="Paul J" first="J." last="Paul">J. Paul</name><affiliation><mods:affiliation>Public Health Laboratory Services, Oxford, U.K.</mods:affiliation></affiliation></author><author><name sortKey="Batchelor, B" sort="Batchelor, B" uniqKey="Batchelor B" first="B." last="Batchelor">B. Batchelor</name><affiliation><mods:affiliation>Public Health Laboratory Services, Oxford, U.K.</mods:affiliation></affiliation></author><author><name sortKey="Amir, M" sort="Amir, M" uniqKey="Amir M" first="M." last="Amir">M. Amir</name><affiliation><mods:affiliation>Kenya Medical Research Institute, Nairobi, Kenya</mods:affiliation></affiliation></author><author><name sortKey="Kimari, J" sort="Kimari, J" uniqKey="Kimari J" first="J." last="Kimari">J. Kimari</name><affiliation><mods:affiliation>Kenya Medical Research Institute, Nairobi, Kenya</mods:affiliation></affiliation></author><author><name sortKey="Mwachari, C" sort="Mwachari, C" uniqKey="Mwachari C" first="C." last="Mwachari">C. Mwachari</name><affiliation><mods:affiliation>Kenya Medical Research Institute, Nairobi, Kenya</mods:affiliation></affiliation></author><author><name sortKey="Bwayo, J" sort="Bwayo, J" uniqKey="Bwayo J" first="J." last="Bwayo">J. Bwayo</name><affiliation><mods:affiliation>Department of Medical Microbiology, University of Nairobi, Kenya</mods:affiliation></affiliation></author><author><name sortKey="Plummer, F" sort="Plummer, F" uniqKey="Plummer F" first="F." last="Plummer">F. Plummer</name><affiliation><mods:affiliation>Department of Medical Microbiology, University of Nairobi, Kenya</mods:affiliation></affiliation></author><author><name sortKey="Gachihi, G" sort="Gachihi, G" uniqKey="Gachihi G" first="G." last="Gachihi">G. 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Gilks</name><affiliation><mods:affiliation>Kenya Medical Research Institute, Nairobi, Kenya</mods:affiliation></affiliation><affiliation><mods:affiliation>Liverpool School of Tropical Medicine, Liverpool, U.K.</mods:affiliation></affiliation><affiliation><mods:affiliation>Address correspondence to: Dr Charles Gilks, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Infection</title><title level="j" type="abbrev">YJINF</title><idno type="ISSN">0163-4453</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1996">1996</date><biblScope unit="volume">33</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="33">33</biblScope><biblScope unit="page" to="37">37</biblScope></imprint><idno type="ISSN">0163-4453</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0163-4453</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antimicrobial</term><term>Antimicrobial activity</term><term>Antimicrobial susceptibilities</term><term>Asymptomatic</term><term>Asymptomatic bacteriuria</term><term>Bacteriuria</term><term>Cell counts</term><term>Clinical manifestations</term><term>Clinical signs</term><term>Colony counts</term><term>Community clinic</term><term>Escherichia coli</term><term>Exact test</term><term>High rates</term><term>Higher rates</term><term>Immunocompetent women</term><term>Immunosuppression</term><term>Infection</term><term>Kenyan women</term><term>Lancet</term><term>Loin pain</term><term>Loin tenderness</term><term>Mycobacterial culture</term><term>Present study</term><term>Pyuria</term><term>Recent study</term><term>Seropositive</term><term>Sexual activity</term><term>Sexual intercourse</term><term>Significant association</term><term>Significant bacteriuria</term><term>Smelly urine</term><term>Study period</term><term>Susceptibility testing</term><term>Tract infection</term><term>Urinary</term><term>Urinary infection</term><term>Urinary tract</term><term>Urinary tract infection</term><term>Urinary tract infections</term><term>Urine</term><term>Urine culture</term><term>Urine samples</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Antimicrobial</term><term>Antimicrobial activity</term><term>Antimicrobial susceptibilities</term><term>Asymptomatic</term><term>Asymptomatic bacteriuria</term><term>Bacteriuria</term><term>Cell counts</term><term>Clinical manifestations</term><term>Clinical signs</term><term>Colony counts</term><term>Community clinic</term><term>Escherichia coli</term><term>Exact test</term><term>High rates</term><term>Higher rates</term><term>Immunocompetent women</term><term>Immunosuppression</term><term>Infection</term><term>Kenyan women</term><term>Lancet</term><term>Loin pain</term><term>Loin tenderness</term><term>Mycobacterial culture</term><term>Present study</term><term>Pyuria</term><term>Recent study</term><term>Seropositive</term><term>Sexual activity</term><term>Sexual intercourse</term><term>Significant association</term><term>Significant bacteriuria</term><term>Smelly urine</term><term>Study period</term><term>Susceptibility testing</term><term>Tract infection</term><term>Urinary</term><term>Urinary infection</term><term>Urinary tract</term><term>Urinary tract infection</term><term>Urinary tract infections</term><term>Urine</term><term>Urine culture</term><term>Urine samples</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Although significant bacteriuria and urinary tract infection are more common in immunocompetent women than men, studies linking HIV immunosuppression with an increased risk of developing urinary infection have so far only been carried out in men. We therefore examined the relationship between bacteriuria and HIV status and CD4+cell count in a relatively homogenous cohort of female commercial sex workers (CSW) attending a community clinic in Nairobi. Two hundred and twenty-two women were enroled, and grouped according to HIV status and CD4 count. Group 1 were HIV seronegative (n = 52); Group 2 were HIV seropositive with CD4 + counts above 500 × 106/1 (n = 51); Group 3 were HIV seropositive with CD4 + counts between 201 and 500 × 106/1 (n = 67); Group 4 were HIV seropositive with CD4 + counts below 200 × 106/1 (n = 52). Clinical signs and symptoms were noted and mid-stream specimens of urine obtained for culture and sensitivity.Overall 23% (50/222) had significant bacteriuria. The rates in each group respectively were 25%, 29%, 19% and 23% and there was no significant association between bacteriuria and HIV status; or between bacteriuria and level of immunosuppression as indicated by CD4 + count. Overall 19% (30/222) of women had symptoms (frequency; dysuria; loin pain; smelly urine) or signs (fever; loin tenderness) compatible with urinary tract infection. However there was no significant association between symptoms or signs of infection and bacteriuria or HIV status. A typical range of pathogens, predominantly Enterobacteriaceae, were isolated and there were high rates of resistance to commonly used antimicrobials as well as 10% resistance to ciprofloxacin.Although high rates of significant bacteriuria can occur in highly sexually-active women, this appears unrelated to HIV infection or the level of HIV-related immunosuppression and is generally asymptomatic or clinically indistinct.</div></front></TEI><istex><corpusName>elsevier</corpusName><keywords><teeft><json:string>bacteriuria</json:string><json:string>significant bacteriuria</json:string><json:string>immunosuppression</json:string><json:string>pyuria</json:string><json:string>antimicrobial</json:string><json:string>urine</json:string><json:string>seropositive</json:string><json:string>lancet</json:string><json:string>asymptomatic</json:string><json:string>high rates</json:string><json:string>urinary tract infection</json:string><json:string>urinary infection</json:string><json:string>significant association</json:string><json:string>urine culture</json:string><json:string>sexual activity</json:string><json:string>urinary</json:string><json:string>cell counts</json:string><json:string>tract infection</json:string><json:string>loin tenderness</json:string><json:string>loin pain</json:string><json:string>asymptomatic bacteriuria</json:string><json:string>clinical signs</json:string><json:string>sexual intercourse</json:string><json:string>smelly urine</json:string><json:string>clinical manifestations</json:string><json:string>present study</json:string><json:string>antimicrobial susceptibilities</json:string><json:string>escherichia coli</json:string><json:string>susceptibility testing</json:string><json:string>colony counts</json:string><json:string>antimicrobial activity</json:string><json:string>community clinic</json:string><json:string>mycobacterial culture</json:string><json:string>exact test</json:string><json:string>kenyan women</json:string><json:string>study period</json:string><json:string>recent study</json:string><json:string>urinary tract</json:string><json:string>higher rates</json:string><json:string>urine samples</json:string><json:string>urinary tract infections</json:string><json:string>immunocompetent women</json:string><json:string>infection</json:string></teeft></keywords><author><json:item><name>J. Ojoo</name><affiliations><json:string>Kenya Medical Research Institute, Nairobi, Kenya</json:string></affiliations></json:item><json:item><name>J. Paul</name><affiliations><json:string>Public Health Laboratory Services, Oxford, U.K.</json:string></affiliations></json:item><json:item><name>B. Batchelor</name><affiliations><json:string>Public Health Laboratory Services, Oxford, U.K.</json:string></affiliations></json:item><json:item><name>M. Amir</name><affiliations><json:string>Kenya Medical Research Institute, Nairobi, Kenya</json:string></affiliations></json:item><json:item><name>J. Kimari</name><affiliations><json:string>Kenya Medical Research Institute, Nairobi, Kenya</json:string></affiliations></json:item><json:item><name>C. Mwachari</name><affiliations><json:string>Kenya Medical Research Institute, Nairobi, Kenya</json:string></affiliations></json:item><json:item><name>J. Bwayo</name><affiliations><json:string>Department of Medical Microbiology, University of Nairobi, Kenya</json:string></affiliations></json:item><json:item><name>F. Plummer</name><affiliations><json:string>Department of Medical Microbiology, University of Nairobi, Kenya</json:string></affiliations></json:item><json:item><name>G. Gachihi</name><affiliations><json:string>Kenya Medical Research Institute, Nairobi, Kenya</json:string></affiliations></json:item><json:item><name>P. Waiyaki</name><affiliations><json:string>Kenya Medical Research Institute, Nairobi, Kenya</json:string></affiliations></json:item><json:item><name>C. Gilks</name><affiliations><json:string>Kenya Medical Research Institute, Nairobi, Kenya</json:string><json:string>Liverpool School of Tropical Medicine, Liverpool, U.K.</json:string><json:string>Address correspondence to: Dr Charles Gilks, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.</json:string></affiliations></json:item></author><articleId><json:string>9692719X</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>Full-length article</json:string></originalGenre><abstract>Although significant bacteriuria and urinary tract infection are more common in immunocompetent women than men, studies linking HIV immunosuppression with an increased risk of developing urinary infection have so far only been carried out in men. We therefore examined the relationship between bacteriuria and HIV status and CD4+cell count in a relatively homogenous cohort of female commercial sex workers (CSW) attending a community clinic in Nairobi. Two hundred and twenty-two women were enroled, and grouped according to HIV status and CD4 count. Group 1 were HIV seronegative (n = 52); Group 2 were HIV seropositive with CD4 + counts above 500 × 106/1 (n = 51); Group 3 were HIV seropositive with CD4 + counts between 201 and 500 × 106/1 (n = 67); Group 4 were HIV seropositive with CD4 + counts below 200 × 106/1 (n = 52). Clinical signs and symptoms were noted and mid-stream specimens of urine obtained for culture and sensitivity.Overall 23% (50/222) had significant bacteriuria. The rates in each group respectively were 25%, 29%, 19% and 23% and there was no significant association between bacteriuria and HIV status; or between bacteriuria and level of immunosuppression as indicated by CD4 + count. Overall 19% (30/222) of women had symptoms (frequency; dysuria; loin pain; smelly urine) or signs (fever; loin tenderness) compatible with urinary tract infection. However there was no significant association between symptoms or signs of infection and bacteriuria or HIV status. A typical range of pathogens, predominantly Enterobacteriaceae, were isolated and there were high rates of resistance to commonly used antimicrobials as well as 10% resistance to ciprofloxacin.Although high rates of significant bacteriuria can occur in highly sexually-active women, this appears unrelated to HIV infection or the level of HIV-related immunosuppression and is generally asymptomatic or clinically indistinct.</abstract><qualityIndicators><score>5.99</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 800 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1917</abstractCharCount><pdfWordCount>2990</pdfWordCount><pdfCharCount>17706</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>294</abstractWordCount></qualityIndicators><title>Bacteriuria in a cohort of predominantly HIV-1 seropositive female commercial sex workers in Nairobi, 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Kenya</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>©1996 The British Society for the Study of Infection</p></availability><date>1996</date></publicationStmt><notesStmt><note type="content">Section title: Original article</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Bacteriuria in a cohort of predominantly HIV-1 seropositive female commercial sex workers in Nairobi, Kenya</title><author xml:id="author-0000"><persName><forename type="first">J.</forename><surname>Ojoo</surname></persName><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation></author><author xml:id="author-0001"><persName><forename type="first">J.</forename><surname>Paul</surname></persName><affiliation>Public Health Laboratory Services, Oxford, U.K.</affiliation></author><author xml:id="author-0002"><persName><forename type="first">B.</forename><surname>Batchelor</surname></persName><affiliation>Public Health Laboratory Services, Oxford, U.K.</affiliation></author><author xml:id="author-0003"><persName><forename type="first">M.</forename><surname>Amir</surname></persName><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation></author><author xml:id="author-0004"><persName><forename type="first">J.</forename><surname>Kimari</surname></persName><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation></author><author xml:id="author-0005"><persName><forename type="first">C.</forename><surname>Mwachari</surname></persName><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation></author><author xml:id="author-0006"><persName><forename type="first">J.</forename><surname>Bwayo</surname></persName><affiliation>Department of Medical Microbiology, University of Nairobi, Kenya</affiliation></author><author xml:id="author-0007"><persName><forename type="first">F.</forename><surname>Plummer</surname></persName><affiliation>Department of Medical Microbiology, University of Nairobi, Kenya</affiliation></author><author xml:id="author-0008"><persName><forename type="first">G.</forename><surname>Gachihi</surname></persName><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation></author><author xml:id="author-0009"><persName><forename type="first">P.</forename><surname>Waiyaki</surname></persName><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation></author><author xml:id="author-0010"><persName><forename type="first">C.</forename><surname>Gilks</surname></persName><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation><affiliation>Liverpool School of Tropical Medicine, Liverpool, U.K.</affiliation><affiliation>Address correspondence to: Dr Charles Gilks, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.</affiliation></author><idno type="istex">290FA3DB06CDF3914ED0E57BD2DFECB144815DF8</idno><idno type="DOI">10.1016/S0163-4453(96)92719-X</idno><idno type="PII">S0163-4453(96)92719-X</idno><idno type="ArticleID">9692719X</idno></analytic><monogr><title level="j">Journal of Infection</title><title level="j" type="abbrev">YJINF</title><idno type="pISSN">0163-4453</idno><idno type="PII">S0163-4453(00)X0117-X</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1996"></date><biblScope unit="volume">33</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="33">33</biblScope><biblScope unit="page" to="37">37</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1996</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Although significant bacteriuria and urinary tract infection are more common in immunocompetent women than men, studies linking HIV immunosuppression with an increased risk of developing urinary infection have so far only been carried out in men. We therefore examined the relationship between bacteriuria and HIV status and CD4+cell count in a relatively homogenous cohort of female commercial sex workers (CSW) attending a community clinic in Nairobi. Two hundred and twenty-two women were enroled, and grouped according to HIV status and CD4 count. Group 1 were HIV seronegative (n = 52); Group 2 were HIV seropositive with CD4 + counts above 500 × 106/1 (n = 51); Group 3 were HIV seropositive with CD4 + counts between 201 and 500 × 106/1 (n = 67); Group 4 were HIV seropositive with CD4 + counts below 200 × 106/1 (n = 52). Clinical signs and symptoms were noted and mid-stream specimens of urine obtained for culture and sensitivity.Overall 23% (50/222) had significant bacteriuria. The rates in each group respectively were 25%, 29%, 19% and 23% and there was no significant association between bacteriuria and HIV status; or between bacteriuria and level of immunosuppression as indicated by CD4 + count. Overall 19% (30/222) of women had symptoms (frequency; dysuria; loin pain; smelly urine) or signs (fever; loin tenderness) compatible with urinary tract infection. However there was no significant association between symptoms or signs of infection and bacteriuria or HIV status. A typical range of pathogens, predominantly Enterobacteriaceae, were isolated and there were high rates of resistance to commonly used antimicrobials as well as 10% resistance to ciprofloxacin.Although high rates of significant bacteriuria can occur in highly sexually-active women, this appears unrelated to HIV infection or the level of HIV-related immunosuppression and is generally asymptomatic or clinically indistinct.</p></abstract></profileDesc><revisionDesc><change when="1996">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/290FA3DB06CDF3914ED0E57BD2DFECB144815DF8/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.0.1//EN//XML" URI="art501.dtd" name="istex:docType"></istex:docType><istex:document><article version="5.0" xml:lang="en" docsubtype="fla"><item-info><jid>YJINF</jid><aid>9692719X</aid><ce:pii>S0163-4453(96)92719-X</ce:pii><ce:doi>10.1016/S0163-4453(96)92719-X</ce:doi><ce:copyright type="unknown" year="1996">The British Society for the Study of Infection</ce:copyright></item-info><head><ce:dochead><ce:textfn>Original article</ce:textfn></ce:dochead><ce:title>Bacteriuria in a cohort of predominantly HIV-1 seropositive female commercial sex workers in Nairobi, Kenya</ce:title><ce:author-group><ce:author><ce:given-name>J.</ce:given-name><ce:surname>Ojoo</ce:surname><ce:cross-ref refid="aff1"><ce:sup>1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>J.</ce:given-name><ce:surname>Paul</ce:surname><ce:cross-ref refid="aff2"><ce:sup>2</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>B.</ce:given-name><ce:surname>Batchelor</ce:surname><ce:cross-ref refid="aff2"><ce:sup>2</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>M.</ce:given-name><ce:surname>Amir</ce:surname><ce:cross-ref refid="aff1"><ce:sup>1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>J.</ce:given-name><ce:surname>Kimari</ce:surname><ce:cross-ref refid="aff1"><ce:sup>1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>C.</ce:given-name><ce:surname>Mwachari</ce:surname><ce:cross-ref refid="aff1"><ce:sup>1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>J.</ce:given-name><ce:surname>Bwayo</ce:surname><ce:cross-ref refid="aff3"><ce:sup>3</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>F.</ce:given-name><ce:surname>Plummer</ce:surname><ce:cross-ref refid="aff3"><ce:sup>3</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>G.</ce:given-name><ce:surname>Gachihi</ce:surname><ce:cross-ref refid="aff1"><ce:sup>1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>P.</ce:given-name><ce:surname>Waiyaki</ce:surname><ce:cross-ref refid="aff1"><ce:sup>1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>C.</ce:given-name><ce:surname>Gilks</ce:surname><ce:cross-ref refid="aff1"><ce:sup>1</ce:sup></ce:cross-ref><ce:cross-ref refid="aff4"><ce:sup>4</ce:sup></ce:cross-ref><ce:cross-ref refid="cor1"><ce:sup>*</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="aff1"><ce:label>1</ce:label><ce:textfn>Kenya Medical Research Institute, Nairobi, Kenya</ce:textfn></ce:affiliation><ce:affiliation id="aff2"><ce:label>2</ce:label><ce:textfn>Public Health Laboratory Services, Oxford, U.K.</ce:textfn></ce:affiliation><ce:affiliation id="aff3"><ce:label>3</ce:label><ce:textfn>Department of Medical Microbiology, University of Nairobi, Kenya</ce:textfn></ce:affiliation><ce:affiliation id="aff4"><ce:label>4</ce:label><ce:textfn>Liverpool School of Tropical Medicine, Liverpool, U.K.</ce:textfn></ce:affiliation><ce:correspondence id="cor1"><ce:label>*</ce:label><ce:text>Address correspondence to: Dr Charles Gilks, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.</ce:text></ce:correspondence></ce:author-group><ce:date-accepted day="11" month="3" year="1996"></ce:date-accepted><ce:abstract id="ab1" class="author" xml:lang="en"><ce:abstract-sec><ce:simple-para>Although significant bacteriuria and urinary tract infection are more common in immunocompetent women than men, studies linking HIV immunosuppression with an increased risk of developing urinary infection have so far only been carried out in men. We therefore examined the relationship between bacteriuria and HIV status and CD<ce:inf loc="post">4</ce:inf>+cell count in a relatively homogenous cohort of female commercial sex workers (CSW) attending a community clinic in Nairobi. Two hundred and twenty-two women were enroled, and grouped according to HIV status and CD<ce:inf loc="post">4</ce:inf> count. Group 1 were HIV seronegative (<ce:italic>n</ce:italic> = 52); Group 2 were HIV seropositive with CD<ce:inf loc="post">4</ce:inf> + counts above 500 × 10<ce:sup loc="post">6</ce:sup>/1 (<ce:italic>n</ce:italic> = 51); Group 3 were HIV seropositive with CD<ce:inf loc="post">4</ce:inf> + counts between 201 and 500 × 10<ce:sup loc="post">6</ce:sup>/1 (<ce:italic>n</ce:italic> = 67); Group 4 were HIV seropositive with CD<ce:inf loc="post">4</ce:inf> + counts below 200 × 10<ce:sup loc="post">6</ce:sup>/1 (<ce:italic>n</ce:italic> = 52). Clinical signs and symptoms were noted and mid-stream specimens of urine obtained for culture and sensitivity.</ce:simple-para><ce:simple-para>Overall 23% (50/222) had significant bacteriuria. The rates in each group respectively were 25%, 29%, 19% and 23% and there was no significant association between bacteriuria and HIV status; or between bacteriuria and level of immunosuppression as indicated by CD<ce:inf loc="post">4</ce:inf> + count. Overall 19% (30/222) of women had symptoms (frequency; dysuria; loin pain; smelly urine) or signs (fever; loin tenderness) compatible with urinary tract infection. However there was no significant association between symptoms or signs of infection and bacteriuria or HIV status. A typical range of pathogens, predominantly <ce:italic>Enterobacteriaceae</ce:italic>, were isolated and there were high rates of resistance to commonly used antimicrobials as well as 10% resistance to ciprofloxacin.</ce:simple-para><ce:simple-para>Although high rates of significant bacteriuria can occur in highly sexually-active women, this appears unrelated to HIV infection or the level of HIV-related immunosuppression and is generally asymptomatic or clinically indistinct.</ce:simple-para></ce:abstract-sec></ce:abstract></head><tail><ce:bibliography><ce:section-title>References</ce:section-title><ce:bibliography-sec><ce:bib-reference id="bib1"><ce:label>1</ce:label><sb:reference><sb:contribution langtype="en"><sb:authors><sb:author><ce:surname>Kunin</ce:surname><ce:given-name>CM</ce:given-name></sb:author></sb:authors><sb:title><sb:maintitle>Urinary tract infections in females</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Clin 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elderly</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Lancet</sb:maintitle></sb:title><sb:volume-nr>344</sb:volume-nr></sb:series><sb:date>1994</sb:date></sb:issue><sb:pages><sb:first-page>1779</sb:first-page><sb:last-page>1780</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference></ce:bibliography-sec></ce:bibliography></tail></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Bacteriuria in a cohort of predominantly HIV-1 seropositive female commercial sex workers in Nairobi, Kenya</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Bacteriuria in a cohort of predominantly HIV-1 seropositive female commercial sex workers in Nairobi, Kenya</title></titleInfo><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Ojoo</namePart><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Paul</namePart><affiliation>Public Health Laboratory Services, Oxford, U.K.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B.</namePart><namePart type="family">Batchelor</namePart><affiliation>Public Health Laboratory Services, Oxford, U.K.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Amir</namePart><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Kimari</namePart><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">Mwachari</namePart><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Bwayo</namePart><affiliation>Department of Medical Microbiology, University of Nairobi, Kenya</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">F.</namePart><namePart type="family">Plummer</namePart><affiliation>Department of Medical Microbiology, University of Nairobi, Kenya</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G.</namePart><namePart type="family">Gachihi</namePart><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P.</namePart><namePart type="family">Waiyaki</namePart><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">Gilks</namePart><affiliation>Kenya Medical Research Institute, Nairobi, Kenya</affiliation><affiliation>Liverpool School of Tropical Medicine, Liverpool, U.K.</affiliation><affiliation>Address correspondence to: Dr Charles Gilks, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1996</dateIssued><copyrightDate encoding="w3cdtf">1996</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Although significant bacteriuria and urinary tract infection are more common in immunocompetent women than men, studies linking HIV immunosuppression with an increased risk of developing urinary infection have so far only been carried out in men. We therefore examined the relationship between bacteriuria and HIV status and CD4+cell count in a relatively homogenous cohort of female commercial sex workers (CSW) attending a community clinic in Nairobi. Two hundred and twenty-two women were enroled, and grouped according to HIV status and CD4 count. Group 1 were HIV seronegative (n = 52); Group 2 were HIV seropositive with CD4 + counts above 500 × 106/1 (n = 51); Group 3 were HIV seropositive with CD4 + counts between 201 and 500 × 106/1 (n = 67); Group 4 were HIV seropositive with CD4 + counts below 200 × 106/1 (n = 52). Clinical signs and symptoms were noted and mid-stream specimens of urine obtained for culture and sensitivity.Overall 23% (50/222) had significant bacteriuria. The rates in each group respectively were 25%, 29%, 19% and 23% and there was no significant association between bacteriuria and HIV status; or between bacteriuria and level of immunosuppression as indicated by CD4 + count. Overall 19% (30/222) of women had symptoms (frequency; dysuria; loin pain; smelly urine) or signs (fever; loin tenderness) compatible with urinary tract infection. However there was no significant association between symptoms or signs of infection and bacteriuria or HIV status. A typical range of pathogens, predominantly Enterobacteriaceae, were isolated and there were high rates of resistance to commonly used antimicrobials as well as 10% resistance to ciprofloxacin.Although high rates of significant bacteriuria can occur in highly sexually-active women, this appears unrelated to HIV infection or the level of HIV-related immunosuppression and is generally asymptomatic or clinically indistinct.</abstract><note type="content">Section title: Original article</note><relatedItem type="host"><titleInfo><title>Journal of Infection</title></titleInfo><titleInfo type="abbreviated"><title>YJINF</title></titleInfo><genre type="journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">199607</dateIssued></originInfo><identifier type="ISSN">0163-4453</identifier><identifier type="PII">S0163-4453(00)X0117-X</identifier><part><date>199607</date><detail type="volume"><number>33</number><caption>vol.</caption></detail><detail type="issue"><number>1</number><caption>no.</caption></detail><extent unit="issue pages"><start>1</start><end>69</end></extent><extent unit="pages"><start>33</start><end>37</end></extent></part></relatedItem><identifier type="istex">290FA3DB06CDF3914ED0E57BD2DFECB144815DF8</identifier><identifier type="DOI">10.1016/S0163-4453(96)92719-X</identifier><identifier type="PII">S0163-4453(96)92719-X</identifier><identifier type="ArticleID">9692719X</identifier><accessCondition type="use and reproduction" contentType="copyright">©1996 The British Society for the Study of Infection</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>The British Society for the Study of Infection, ©1996</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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