尼日利亚西南部萨加穆地区HIV阳性和阴性孕妇无症状菌尿的决定因素

Determinants of Asymptomatic Bacteriuria in HIV-positive and Negative Pregnant Women in Sagamu, South-West Nigeria.

作者信息

Akadri A A, Odelola O I

机构信息

Departments of Obstetrics and Gynaecology, Babcock University, Ilishan-Remo, Ogun State, Nigeria.

Department of Obstetrics and Gynecology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.

出版信息

West Afr J Med. 2020 Jan-Mar;37(1):1-6.

PMID:32030704

Abstract

BACKGROUND

Pregnant women with asymptomatic bacteriuria are at increased risk of developing symptomatic urinary tract infections. HIV infection may modify the acquisition of bacteriuria in pregnancy.

OBJECTIVE

To identify the determinants of asymptomatic bacteriuria in HIV-positive and HIV-negative pregnant women in Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.

METHODS

A cross-sectional study involving 211 HIV-positive pregnant women and 422 HIV-negative pregnant women attending their first antenatal clinic between October 2017 and March 2018. Information on socio-demographic characteristics and risk factors for asymptomatic bacteriuria in study participants was recorded. Microbial culture was carried out on aseptically collected urine samples.

RESULTS

Asymptomatic bacteriuria was found in 66(31.3%) and 118(28.0%) in HIV-positive and negative women respectively. Advanced maternal age, gestational age above 20 weeks, low socioeconomic status, history of urinary tract infections in previous pregnancies and low CD4 cell count had statistically significant association with increased prevalence of asymptomatic bacteriuria among HIV positive women. Binary logistic regression analysis showed that low socioeconomic status and history of urinary tract infections in previous pregnancies were strong determinants of asymptomatic bacteriuria among HIV positive women (AOR 4.1, CI 1.9-8.7, P < 0.001; AOR 5.8, CI 2.5-13.6, P < 0.001 respectively). In HIV negative women, gestational age above 20 weeks had statistically significant association with increased prevalence of asymptomatic bacteriuria (AOR= 2.34, CI 1.3-4.1, P= 0.002).

CONCLUSION

Low socioeconomic status and previous history of urinary tract infections are determinants of asymptomatic bacteriuria in HIV positive women while gestational age above 20 weeks is a determinant in HIV negative women. These determinants could be used to identify women at high risk of asymptomatic bacteriuria for targeted screening.

摘要

背景

无症状菌尿的孕妇发生有症状尿路感染的风险增加。HIV感染可能改变孕期菌尿的发生情况。

目的

确定尼日利亚萨加穆奥拉比西·奥纳班乔大学教学医院HIV阳性和HIV阴性孕妇无症状菌尿的决定因素。

方法

一项横断面研究，纳入了2017年10月至2018年3月期间首次到产前诊所就诊的211名HIV阳性孕妇和422名HIV阴性孕妇。记录研究参与者的社会人口学特征和无症状菌尿的危险因素信息。对无菌采集的尿液样本进行微生物培养。

结果

HIV阳性和阴性女性中无症状菌尿的发生率分别为66例（31.3%）和118例（28.0%）。高龄产妇、孕周超过20周、社会经济地位低、既往妊娠有尿路感染史以及CD4细胞计数低与HIV阳性女性无症状菌尿患病率增加具有统计学显著相关性。二元逻辑回归分析显示，社会经济地位低和既往妊娠有尿路感染史是HIV阳性女性无症状菌尿的重要决定因素（调整后比值比分别为4.1，可信区间1.9 - 8.7，P < 0.001；调整后比值比为5.8，可信区间2.5 - 13.6，P < 0.001）。在HIV阴性女性中，孕周超过20周与无症状菌尿患病率增加具有统计学显著相关性（调整后比值比 = 2.34，可信区间1.3 - 4.1，P = 0.002）。