Les Infections Urinaires Bactériennes chez les PVVIH : Une Étude Transversale au Service des Maladies Infectieuses du CHU Point G

RESUME Introduction. Les infections urinaires sont frequentes sur les terrains d’immunodepression. Le but de notre etude etait de decrire les aspects epidemiologiques, cliniques et bacteriologiques des infections urinaires d’origine bacteriennes chez les PVVIH dans le service des maladies infectieuses du CHU de Point ‘‘G’’,  du 1er janvier 2014 au 31decembre 2016. Methodes. Le diagnostic de l’infection urinaire a ete retenu sur la base de la presence d’une leucocyturie superieure ou egale a 10000 leucocytes/ml avec ou sans hematurie et/ou l’isolement d’une bacterie a l’uroculture.  Resultats. La prevalence des infections urinaires bacteriennes a ete de 4,30% (n=48). Les principaux signes cliniques ont ete les brulures mictionnelles (n=5), la pollakiurie (n=2) et la pyurie (n=1).  Escherichia coli a ete trouve dans 59,52% (n=25) des cas et  avaient une sensibilite de 90,09% (n=22) a l’imipeneme, 88% (n=25) a la colistine, 69,23% (n=13) au cefotaxime. La resistance etait superieure a 65% pour les antibiotiques utilises en routine comme la doxycycline 84,61% (n=13), association amoxicilline acide clavulanique 73,33% (n=15), la gentamicine 68,75% (n=16), la ciprofloxacine 66,66% (n=15) et le ceftriaxone 66,66% (n=15). Dans 100% des cas, nos souches etaient resistantes au trimethoprime. Conclusion. Devant cette augmentation croissante de germes multi resistants, l’antibiotherapie de premiere intention en matiere d’infection urinaire merite d’etre redefinie apres une etude nationale sur l’ecologie et la sensibilite bacterienne. ABSTRACT Objective. Urinary tract infections are common in immunosuppression sites. The purpose of this study was to describe the epidemiological, clinical and bacteriological aspects of bacterial urinary tract infections in people living with HIV in the CHU point G. Population and methods. This study took place from 1 January 2014 to 31 December 2016 in the infectious diseases department of CHU Point G. The diagnosis of urinary tract infection was based on the presence of leukocyturia greater than or equal to 10,000 leukocytes/ml with or without hematuria and/or the isolation of a bacterium from the uroculture. Results. The prevalence of bacterial urinary infections was 4.30% (n = 48). The main clinical signs were urinary burns (n = 5), pollakiuria (n = 2) and pyuria (n = 1). Escherichia coli was found in 59.52% (n = 25) of the cases and had a sensitivity of 90.09% (n = 22) to imipenem, 88% (n = 25) to colistin, 69.23 % (n = 13) to cefotaxime. However, the resistance exceeded 65% with antibiotics used routinely as doxycycline 84.61% (n = 13), amoxicillin combination clavulanic acid 73.33% (n = 15), gentamicin 68.75% (n = 16), ciprofloxacin 66.66% (n = 15) and ceftriaxone 66.66% (n = 15). In 100% of cases our strains were resistant to trimethoprim. Conclusion. In view of this growing increase of multi-resistant germ, first-line antibiotic therapy for urinary tract infection deserves to be redefined after a national study on ecology and bacterial sensitivity.