Antimicrobial resistance profile of uropathogens: A comparative study in people living with HIV and Non-HIV individuals

Urinary tract infections (UTIs) represent a significant portion of the most commonly encountered bacterial infections globally, with the intricacies of this issue being exacerbated by the phenomenon of antimicrobial resistance (AMR), particularly within susceptible populations such as individuals living with HIV (PLHIV). The objective of this investigation was to evaluate the prevalence, categorization of bacterial agents, and patterns of antimicrobial susceptibility among uropathogens in both HIV-positive and HIV-negative cohorts in Owerri, Nigeria. A croaa sectional study was executed comprising 150 participants, evenly distributed with 75 HIV-positive and 75 HIV-negative individuals, all of whom were receiving care at the Federal University Teaching Hospital in Owerri. Midstream urine specimens were collected, cultured on standard bacteriological media, and the resulting isolates were identified via biochemical analysis. In order to evaluate antimicrobial susceptibility, Kirby–Bauer disk diffusion methodology was employed in accordance with CLSI (2017) standards. The data were subjected to analysis using Chi-square tests, with a significance threshold set at p < 0.05. The cumulative prevalence of UTIs was identified as 66.0%, with a markedly elevated occurrence among HIV-positive individuals (74.7%) in comparison to their HIV-negative counterparts (57.3%) (χ² = 4.92, p = 0.027). The demographic cohort aged 30-39 years exhibited the highest rates of infection, and a greater prevalence was observed among females in both groups (p = 0.008). Escherichia coli (32.3%) was identified as the predominant isolate, followed by Staphylococcus aureus (24.1%) and Klebsiella spp. (14.1%). The highest levels of susceptibility were noted for fluoroquinolones and amoxicillin–clavulanate, whereas amoxicillin and cotrimoxazole demonstrated suboptimal effectiveness. Resistance profiles remained comparable across both cohorts (p > 0.05). This research underscores the fact that HIV infection significantly elevates the likelihood of UTIs and that the escalating challenge posed by antimicrobial resistance represents a formidable barrier to effective treatment. Continuous surveillance, culture-guided therapeutic interventions, and judicious use of antimicrobials are imperative for addressing resistance. The integration of microbiological surveillance within HIV management programs is highly advocated.