L'ASSOCIATION INFECTION URINAIRE ET INFECTION VIH A DANS LE SERVICE DE MEDECINE INTERNE DE L'HOPITAL DU POINT G - BAMAKO - MALI. ASSOCIATION OF URINARY TRACT INFECTIONS AND HIV INFECTION IN AN INTERNAL MEDECINE WARD OF HOSPITAL OF POINT G - BAMAKO - MALI

We gathered 14 clinical observations of urinary track infections in AIDS patients in Internal Medicine wards from August 1, 1998 to July 31, 1999. Urinary track infection and HIV were both present in 1.75% of 797 hospitalized patients. The specific prevalence Was 14.43% among AIDS patients. The sex ratio (female /male) was 1.33. The mean age of patients was 37.2 years with ranges between 25 years and 59 years. Urinary symptoms were discret. Urinary tract infection was primarily evidenced by urine leucocytes > 104organism/ml and a bacteriuria > 105 colony- forming units/ml. The main pathogens were Escherichia coli (42.85%), Klebsiella pneumoniae (28.57%), Colibacilles spp. (21.42%) and Enterobacter cloacae (7.14%). All isolated germs were sensible to the gentamicin, to the amikacin, to the nalidixic acid, to the cefoxitine, to the ceftazidime to the cefotaxime and the ciprofloxacin. Cephalosporin of 3rd generation, aminoglycosides, and fluoroquinolone can be used like treatment of first line in urinary tract infection suspicion case in Bamako. Our patients were highly immunosuppressed with the majority of them being in class IV C of CDC of Atlanta(90 %) and CD4 count constantly bellow 200 cells/mm3. The main opportunistic affections were non bacilar bacterial pneumopathies (28.57%), oesophagal mycosis (71.42%), the association of cerebral toxoplasmosis and pulmonary tuberculosis (35.71%). All urinary infections were cured by mean of 5 days of treatment. Very few recidive was found (1