URINARY-TRACT INFECTION IN MEN WITH AIDS

Objective-To investigate whether bacteriuria and, specifically, sympto matic urinary tract infection (UTI) occur with increased frequency in men with HIV infection. Methods-In this cross-sectional study we inves tigated three groups of men, aged from 18 to 50 years. Group A was com posed of patients with a diagnosis of AIDS; Group B, of patients witho ut HIV infection, and group C of patients with asymptomatic HIV infect ion. Patients with any known predisposing factor for UTI were excluded from the study. A clean-catch midstream urine sample was collected fr om each patient on the first day of hospital admission (groups A and B ) or during a visit to the outpatient clinic (group C). Bacteriuria wa s diagnosed when greater than or equal to 100 000 colony forming units /ml, urine were grown. Results-There were 415 patients, 151 in group A , 170 in group B and 94 in group C. Bacteriuria was significantly more frequent in group A (20 cases, 13.3%) than in groups B (3 cases, 1.8% , p = 0.00007) and C (3 cases, 3.2%, p = 0.009). Ten cases of bacteriu ria in group A (6 6%) were symptomatic while no case of symptomatic UT I was seen in groups B (p = 0.0004) and C (p = 0.008). The frequency o f UTI in homosexual men with AIDS (7 cases, 6.7%) was not significantl y different from that observed in men with AIDS who denied homosexuali ty (3 cases, 6.5%). E coli was the predominant pathogen associated wit h UTI. Although adequate response to a two-week course of antibiotics was observed in most cases, an in-hospital mortality rate of 20% was f ound among AIDS patients with symptomatic UTI. Conclusions-In the pres ent study, the frequency of bacteriuria and symptomatic UTI was found to be increased in men with AIDS. E coli was the predominant pathogen in these cases. These data suggest that symptomatic UTI may represent a relevant cause of morbidity for men with AIDS.