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

A systematic review and meta-analysis estimated the global prevalence of bacterial urinary tract infections among people living with HIV/AIDS at 18%, based on 37 studies that together included 14,318 participants. The pooled estimate had a 95% confidence interval of 15–21%, while statistical heterogeneity was extremely high at I² = 98.5%. Among the selected bacterial uropathogens, Escherichia coli had the highest pooled proportion, at 45% (95% CI: 37–53%; I² = 93.2%).

Researchers conducted a comprehensive literature search to identify eligible studies examining bacterial urinary tract infections and common uropathogenic bacteria among people living with HIV/AIDS. They calculated pooled prevalence estimates with a random-effects model, assessed heterogeneity using the I² statistic and performed the statistical analyses in Stata version 14.0. The final analysis included 37 studies and 14,318 people living with HIV/AIDS. Because the overall I² value reached 98.5%, the 18% estimate should be understood as a pooled summary of the included studies rather than a uniform prevalence applicable to every population, location or clinical setting.

Regional subgroup analysis identified Asia as having the highest observed pooled prevalence, at 30% (95% CI: 17–43%; I² = 97.8%). The confidence interval was broad and heterogeneity within the Asian subgroup remained very high. The supplied results did not give comparable numerical estimates for the other regions, so the remaining regional differences could not be quantified. The Asian figure represents the highest prevalence among the reported subgroup estimates; it does not establish a global trend or a change over time.

Pathogen-specific meta-analysis yielded pooled proportions of 45% for Escherichia coli, 13% for Staphylococcus aureus and 12% for Klebsiella pneumoniae. The corresponding 95% confidence intervals were 37–53%, 9–17% and 8–15%, with I² values of 93.2%, 85.6% and 80.8%, respectively. Additional pooled proportions were 6% for Enterobacter species, 11% for Pseudomonas aeruginosa and 11% for Enterococcus species. These are pooled pathogen-specific proportions for the populations assessed; the supplied evidence does not establish that they are the probability of isolating a given organism from any individual urinary tract infection. The review was not a clinical trial and did not directly test a diagnostic strategy, antimicrobial treatment or prevention program. Its findings instead synthesize the reported burden and distribution of bacterial urinary tract infections in people living with HIV/AIDS, supporting the authors’ conclusion that these infections remain clinically important and require timely diagnosis and appropriate empirical treatment.

Subject of Research: Global prevalence and pathogen distribution of bacterial urinary tract infections among people living with HIV/AIDS

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

Article References: Zomorodi, A. R., Askari, S., Aflakian, F., Bahrami, M., Farshi, Z. G., Mahmoodi, A., Azhdari, S., & Motamedifar, M. (2026). Prevalence and distribution of common uropathogenic bacteria among HIV/AIDS patients worldwide: a systematic review and meta-analysis. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14283-6

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14283-6

Keywords: HIV/AIDS, urinary tract infections, uropathogenic bacteria, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, systematic review, meta-analysis, prevalence, pathogen distribution, distribution, common