Abstract
Background
The aim of the current study was to determine whether there is an association between
alkaptonuria (AKU) and urinary tract infection (UTI) by exploring the bacterial quality
of the urinary tract, as most of the patients with AKU present with frequent occurrence
of urinary tract symptoms such as incomplete emptying of urinary bladder, dysuria
and nocturia.
Methods
Study samples were collected from 22 participants; 9 from patients with AKU, 9 from
individuals who were AKU carriers, and 4 people served as control. Confirmation of
AKU diagnosis was established by the ferric chloride test and quantitative determination
of urinary homogentisic acid (HGA) levels.
Results
In the ferric chloride test, the urine samples of AKU patients showed a characteristic
black ring upon addition of few drops of ferric chloride solution. During urinary
HGA determination, patients with AKU had increased levels of urinary HGA as compared
to carriers and controls. The following 10 bacterial species were isolated from the
urinary tract of AKU patients, carriers and controls: Sphingomonas paucimobilis, Escherichia coli, Francisella tularensis, Staphylococcus
hominis, Staphylococcus haemolyticus, Leuconostoc mesenteroides, Dermacoccus nishinomiyaensis,
Kytococcus sedentarius, Serratia fonticola and Granulicatella adiacens. The presence of S. paucimobilis was found in three male patients, and one female each from the carrier and control
groups. Almost all study samples were positive for D. nishinomiyaensis and K. sedentarius. S. fonticola and G. adiacens were found only in AKU carrier females.
Conclusions
The results deduced that males show symptoms of arthritis early and more severely
than females and by this it appears that there is an association between these symptoms
and the percentage of bacterial infection in males that requires more accurate diagnosis
and treatment to clarify such relationship. In the current study, males (patients,
carriers, and controls) were more likely to have bacterial infections than females
(64% vs. 36%). The 16 and 2 bacterial isolates, detected in 7 males and 2 females
AKU patients, respectively, revealed that male AKU patients had a 2.3-fold greater
rate of bacterial infection than female AKU patients. Therefore, further studies are
warranted to investigate if there's any relationship between higher incidence of bacterial
infections and development of AKU-related clinical symptoms in the male population.
Key Indexing Terms
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Article info
Publication history
Published online: January 02, 2023
Accepted:
December 29,
2022
Received:
December 29,
2021
Identification
Copyright
© 2023 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
