Abstract
BackgroundHuman immunodeficiency virus (HIV) and extended spectrum beta lactamase (ESBL) producing Enterobacteriaceae infections are the major challenges in sub-Saharan Africa. Data on the carriage rate of ESBL producing Enterobacteriaceae among HIV infected children is lacking in Ethiopia. Hence this study was aimed to investigate fecal carriage of ESBL producing Enterobacteriaceae among HIV infected children at the University of Gondar comprehensive Specialized Hospital.MethodsA cross-sectional study was conducted among HIV infected children from January to April 2020. Stool specimens were collected from 161 study participants by convenient sampling and cultured on MacConkey agar. Biochemical identification, antimicrobial susceptibility testing including ESBL production were carried out. Data were analyzed by SPSS version-20 and P-value < 0.05 on multivariate logistic regression analysis was regarded as statistically significant.ResultsFrom a total of 161 study participants male to female ratio was 1:1.1. Moreover; 96.3% of participants were in HIV stage-I and 90.1% had at least a year highly active antiretroviral therapy exposure. A total of 186 Enterobacteriaceae, with E. coli 60% and K. pneumonia 16.13% predominance were isolated from 161 participants. Majority of isolates were most resistant to amoxicillin (95.1%) and sensitive to CHL (94.1%), CXT (91.4%) and CAZ (91.4%). There were 71(38.17%) multidrug resistant isolates, 13 of which were also ESBL producers. The overall ESBL carriage rate was 32/161 (19.9%). History of antibiotic use was the independent factor associated with ESBL carriage (AOR 3.23 (95% CI 1.054–9.88)) and P-value of 0.04.ConclusionESBL carriage rate of HIV infected children was considerable. Previous antibiotic use was the independent factor. Regular screening for antibiotic resistance on HIV patients before prescription and large-scale antibiotic resistance survey including healthy community may be important.
Highlights
Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) infection which damages mucous membrane of intestine, baring the Bayleyegn et al AIDS Res Ther (2021) 18:19 host to antimicrobial resistant infections [1]
Majority of participants were above 10 years (77%), urban residents (87%) and in the World Health Organization (WHO) HIV stage I (96.3%)
Distribution and antimicrobial resistance profile of Enterobacteriaceae Among 161 study participants who brought stool specimen, there were 186 Enterobacteriaceae isolated from stool culture
Summary
Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) infection which damages mucous membrane of intestine, baring the Bayleyegn et al AIDS Res Ther (2021) 18:19 host to antimicrobial resistant infections [1]. A review by Lewis et al in sub Saharan Africa reported a pooled estimate of ESBL carriage as 18%, indicating the highest burden in the region than reports from US and Europe (3.4 to 7.3%) [5]. Bacteria produce β-lactamases, a potent family of enzymes that breakdown β-lactam ring of antibiotics making it ineffective and become a major risk in an increasing burden of resistant infections [6]. Human immunodeficiency virus (HIV) and extended spectrum beta lactamase (ESBL) producing Enterobacteriaceae infections are the major challenges in sub-Saharan Africa. Data on the carriage rate of ESBL producing Enterobacteriaceae among HIV infected children is lacking in Ethiopia.
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