Association of ABH non-secretor phenotype with re-occurrence of urinary tract infections among patients at Mulago Hospital, Kampala

Abstract

Background: ABO Blood group antigens are expressed on red blood cells however, these antigens can also be expressed on other cells especially epithelial cells and also mucosal secretions. In many human populations 80% are secretors and 20% are non-secretors of those mucosal blood group antigens. There are disease conditions that are associated with secretor status, among these, UTIs have been suggested. It is against this background that this study was conducted. Objective: To investigate the association between mucosal blood group antigen non-expression (non-secretor status) and susceptibility to UTIs among patients diagnosed with UTIs at Mulago National Referral Hospital, Kampala. Materials and methods: This was an analytical cross sectional study at Mulago National Referral Hospital, Kampala enrolling 370 UTI patients. Blood and saliva samples were collected for ABO blood grouping and secretor status determination by conventional tile grouping and hemagglutination Inhibition methods respectively. Participant information and socio-demographic information were captured using a short participant questionnaire and data analyzed in SPSS version 26 Results: Out of the 263 UTI patients who consented for study enrollment, 111 were blood group O representing (42.2%), 79 were A (30%), B were 58 (22.1%) and AB had 15 (5.7%). Of the 224 subjects who provided saliva samples, 138 were secretors (61.6%) while 86 were non-secretors (38.4%). Blood group AB had the highest percentage of non-secretors (45.5%) while A had the lowest (34.4%). Only 62 (28.3%) reported to have previously contracted a UTI in the last 12 months, 38 (61.2%) of whom were non-secretors and 24 (38.8%) secretors. Non-secretor status was significantly associated with UTI re-occurrence in 12 months; P-value of 0.00003, 95% confidence intervals (0.139, 0.5214), 3.7 odds ratio. Other risk factors for UTI re-occurrence according to the study were; female sex, pregnancy, sexual activity in the last year and age group of 18-28 or 40-59. Non-secretors with another risk factor were more at risk than either group. Conclusion: Non-secretor status among other UTI risk factors is significantly associated with a susceptibility to UTI re-occurrence. Clinicians should take into account secretor status of patients in the assessment and management of recurrent Urinary Tract Infections.