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Background  People living with HIV may be at increased risk for infections with resistant organisms. Infections with ESBL-producing organisms are of particular concern because they limit treatment options for severe Gram-negative infections in low-resource settings.    Objectives  To investigate the association between HIV status and urinary tract infections (UTIs) with ESBL-producing  Escherichia coli .    Patients and methods  Cross-sectional study enrolling adults presenting with UTI symptoms to primary care clinics in Harare, Zimbabwe. Demographic and clinical data were collected during interviews and a urine sample was collected for culture from each participant. Antimicrobial susceptibility testing was performed according to EUCAST recommendations.    Results  Of the 1164 who were enrolled into the study, 783 (64%) were female and 387 (33%) were HIV infected. The median age was 35.8 years. Urine cultures were positive in 338 (29.0%) participants, and the majority of bacterial isolates were  E. coli  ( n  =   254, 75.2%). The presence of ESBL was confirmed in 49/254 (19.3%)  E. coli . Participants with HIV had a 2.13 (95% CI 1.05–4.32) higher odds of infection with ESBL-producing  E. coli  than individuals without HIV. Also, the prevalence of resistance to most antimicrobials was higher among participants with HIV.    Conclusions  This study found an association between HIV and ESBL-producing  E. coli  in patients presenting with symptoms suggestive of UTI to primary care in Harare. HIV status should be considered when prescribing empirical antimicrobial treatment.

jac-antimicrobial resistance

Prevalence of ESBL-producing <i>Escherichia coli</i> in adults with and without HIV presenting with urinary tract infections to primary care clinics in Zimbabwe

Prevalence of ESBL-producing Escherichia coli in adults with and without HIV presenting with urinary tract infections to primary care clinics in Zimbabwe