Prevalence and genetic lineages of nasal colonization and urinary tract infection among people living with HIV/AIDS in Nigeria: A systematic review.

To provide an empirical insight on nasal colonization and urinary tract infection (UTI) among people living with HIV/AIDS (PLWHA) in Nigeria, a quantitative synthesis and systematic review were executed. A comprehensive bibliometric search was conducted for published articles using the keywords 'nasal carriage', 'Urinary , 'nasal MRSA', 'staphylococci-HIV coinfection', 'urinary MRSA' and 'all states of Nigeria'. Eligible studies and the number of subjects (n) were analysed according to the PRISMA criteria. Out of the 79 examined studies, only 6 (n=1181) and 6 (n= 1350) on nasal and urine samples, respectively, were eligible. The pooled prevalence of nasal carriage and UTI of were 29.6% and 6.8%, respectively. However, the pooled nasal MRSA carriage was 13.4%. The pooled prevalence of -carrying among nasal samples was 13.0%. Molecular typing from 3 studies showed MRSA-ST8-t064 and MSSA-ST15-t084 as the predominant genetic lineages. The isolates from both sample types had the highest (>50%) resistance to penicillin, sulfamethoxazole-trimethoprim, erythromycin, and tetracycline. Multi-drug resistance was not significantly higher among isolates from urine than nasal samples (60% versus 40.0% of eligible studies) (= 0.5271). A moderate and high pooled prevalence of genetically diverse MRSA and -carrying were obtained from PLWHA, respectively. These findings emphasize the importance of routine screening for MRSA among PLWHA in Nigeria and other HIV endemic countries.