Prevalence and distribution of common uropathogenic bacteria among HIV/AIDS patients worldwide: a systematic review and meta-analysis

Urinary tract infections (UTIs) are common among individuals living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) due to immunosuppression, but evidence on the global distribution of uropathogens remains limited. Therefore, this study aimed to estimate the global prevalence of bacterial UTIs and common uropathogenic bacteria among people living with HIV/AIDS (PLWHA). A systematic review and meta-analysis were conducted to estimate the global prevalence of UTIs and common uropathogenic bacteria among PLWHA. A comprehensive literature search was performed to identify eligible studies. Pooled prevalence estimates were calculated using a random-effects model, and heterogeneity was assessed using the I 2 statistic. Statistical analyses were performed using Stata software (version 14.0). A total of 37 studies were included in the final analysis, comprising 14,318 PLWHA. Across the 37 included studies, the pooled prevalence of bacterial UTI among PLWHA was 18% (95% CI: 15–21%; I 2 = 98.5%). Subgroup analysis showed variation across regions, with the highest prevalence observed in Asia (30%; 95% CI: 17–43; I 2 = 97.8%). Pathogen-specific meta-analyses yielded pooled proportions of 45% for Escherichia coli (95% CI: 37–53%; I 2 = 93.2%), 13% for Staphylococcus aureus (95% CI: 9–17%; I 2 = 85.6%), and 12% for Klebsiella pneumoniae (95% CI: 8–15%; I 2 = 80.8%). Additional pathogen-specific pooled estimates were 6% for Enterobacter spp. 11% for Pseudomonas aeruginosa , and 11% for Enterococcus spp. This study demonstrates a considerable burden of bacterial UTIs among PLWHA and provides pathogen-specific pooled estimates for selected bacterial uropathogens, including E. coli . These findings highlight the clinical importance of bacterial UTIs in this population and the need for timely diagnosis and appropriate empirical treatment. Not applicable.