C-Reactive Protein as a Probable Predictor of Urinary Tract Infection in Hiv Seropositive Individuals

Abstract

The aim of the present study is to evaluate the possible use of C-reactive proteins as predictor for urinary tract infection in HIV seropositive individuals. A total of 50 seropositive individuals were selected under purposive sampling during the study period. They consisted of 36 seropositive females and 14 seropositive males. Blood and urine samples were collected from each subject. Isolation of UTI causing species was carried out by standard microbiological methods. Identification of microbial isolates was carried using gram staining techniques, biochemical test and antimicrobial susceptibility techniques. Estimation of Serum C-reactive Protein was carried out by Rapid Quantitative Test using the FineCare CRP rapid quantitative test. Correlation analysis was used to determine and compare whether there is a relationship between the levels of C-reactive protein and the incidence of urinary tract infection in the samples. From the results, of the 50 urine samples of HIV positive individuals collected, only 23 samples recorded microbial growth after culturing for 24 hours in MacConkey agar. Antimicrobial sensitivity test was used to determine the inhibitory activities of different antibiotics on the test bacterial species. A total of 10 antibiotic discs were tested against 23 microbial isolates. Of the 23 organisms tested, 60.87% was resistant to Erythromycin, 34.78% was resistant to Cetraxon, 73.78% was resistant to Ampicillin, 100 % was resistant to Cloxacillin, 8.69% was resistant to LV, 69.56% was resistant to Cephalexin, 17.39 was resistant to Ciprofloxacin, 13.04% was resistant to Gentamycin, 17.40% was resistant to Ofloxacin while 65.21% was resistant to Clindamycin. The result of Gram reaction showed that all microbial isolates were either long or short Gram negative rods. While some of the rods were short and in cluster, some were long and cluster, others were short and single while some were long and single. From the biochemical test, Klebsiella pneumoniae, E. coli, Staphylococcus aureus and Proteus spp were confirmed to be present in the urine samples in quantities that show the absence of urinary tract infection. The result of correlation analysis showed a non-significant negative correlation (p > 0.01) between the bacteria load and the CRP levels of the samples analyzed. There was also a non-significant negative correlation (p > 0.01) between the bacterial load of the samples and hsCRP levels. Although the bacteria load of the urine samples were lower than what could define the presence of UTI, the CRP and hsCRP levels of some samples were very high indicating inflammation or infection in such individuals. The suspected infection could be due to another infection or inflammation but not UTI. Thus, the use of CRP and hsCRP as diagnostic markers for UTI may not be very efficient since some other infections could lead to the increase in the levels of CRP and hsCRP in the absence of UTI.