Bacteriuria in patients with CDC group IV manifestations: a prospective study [letter]

Health practitioners at the University Hospital of the Federal University of Rio de Janeiro in Brazil noted a high frequency of urinary tract infection (UTI) in AIDS patients. Therefore they enrolled 57 consecutive eligible male patients of the AIDS unit into a prospective study of bacteriuria. Exclusion criteria included previous history of UTI or renal stones genitourinary manipulation in the 6 months before the study or clinical evidence of prostatic disease. Average age was 33.47 years (range 21-49 years). Their risk factor distribution mirrored that of the HIV positive male population at the hospital. In included homosexuality/bisexuality (75%) intravenous drug users (7%) blood transfusions (3.5%) and heterosexuality (1.75%). The remaining 12.28% had undetermined risk factors. Laboratory personnel cultured a clean catch midstream urine specimen. Repeat result of >100000 c.f.u./ml and no UTI symptoms or single result of >100000 c.f.u/ml and UTI symptoms defined bacteriuria. 14.04% had bacteriuria. Positive cultures consisted of only gram negative bacilli especially Escherichia coli (62.5%). No one experienced back pain. In addition fever was not necessarily indicative of bacteriuria. 3 patients experienced pain when urinating which approached significance (p=.07). No statistically significant differences occurred in respect to age distribution risk factors history of sexually transmitted diseases hospital admissions or antibiotic use in the 6 months before the study. Since there was no control group it was difficult for the researchers to determine if the prevalence rate was higher than the general population. This study was 1 of few studies on bacteriuria in HIV infected patients. Further studies with control groups that investigate risk factors are needed.