Prevalence, Risk Factors and Antimicrobial Resistance of Enterococci caused Urinary Tract Infection among People Living with HIV in Addis Ababa, Ethiopia.

Abstract

Background: Urinary tract infections (UTIs) are among the most common infections worldwide, affecting millions of people each year. The antimicrobial resistance characteristic of Enterococci worsens complications among this vulnerable population. This study aimed to estimate the prevalence of Enterococci-caused UTIs, their risk factors, and antimicrobial resistance profile among people living with HIV in Addis Ababa, Ethiopia.

Methodology: Hospital-based cross-sectional study was conducted from October 2022 to April 2023. Presumptive Enterococci were identified using standard microbiological culture and biochemical tests and confirmed using Matrix-Assisted Laser Desorption Ionization-Time of Flight of Mass Spectrometry at the species level.

Results: This study revealed that among the (n= 102) people living with HIV-acquired culture-confirmed UTIs with diverse bacterial uropathogens, (n= 20; 19.6%) were acquired UTIs associated with Enterococcus species: E. faecalis 80% and E. faecium 20%. Earning monthly income <3000 Ethiopian birr with (adjusted OR) =3.19; (95% CI: 1.05, 9.66) and having exposure to anti-tuberculosis drugs (Adjusted OR = 13.62; 95%CI: 3.53, 52.63) were positively associated with the occurrence of Enterococci-caused UTI. All Enterococci isolates had multi-drug and extensive drug-resistance strains.

Conclusion: The study concluded a higher prevalence of Enterococci-caused UTIs, with predicting factors: lower income per month, and exposure to antituberculosis drugs, and high level of antimicrobial resistance. Hence, there should be a targeted intervention that could tackle the higher prevalence of infection and antimicrobial resistance among these vulnerable populations, steering the identified predicting factors.