Pattern of pathogens in ear discharge of HIV-infected children in Nnewi, Southeast Nigeria.

Abstract

This is a descriptive, prospective, hospital-based study designed to determine the prevalent organisms in ear infections and their antimicrobial susceptibility patterns in HIV-infected children compared to age-and sex-matched HIV sero-negative patients. Two hundred and fifty eight HIV-infected children being followed up at the Paediatric HIV clinic had their ears examined for middle ear infection. All those with discharging ears had swabs taken. Culture and antimicrobial sensitivities were ascertained. The same was done for another cohort of 57 age-and sex-matched HIV-negative patients with discharging ears. Twenty eight (10.9%) of 258 HIV-infected children had discharging ears and were made up of 13 females and 15 males aged between 7 and 132 months. Out of this number 85.7% had chronically discharging ears, 96.4% of the 28 children acquired the HIV infection vertically. 78.6% had been on antiretroviral drugs from one to twenty-one months. 67.9% of the patients had associated opportunistic infections. Acute ear infections were predominant among the control group. Klebsiella, Proteus, Staphylococcus and Pseudomonas were major pathogens isolated among the HIV-infected group and Streptococcus, Klebsiella and Pseudomonas for the HIV-negative group. A hundred percent sensitivity was recorded among the quinolones for all bacterial organisms isolated. HIV-infected children tend to have more of chronic than acute ear infections and this is reflected in the causative organisms. Similar antimicrobial sensitivity patterns apply to HIV-infected and HIV-negative children. There is a need to revisit the use of quinolones in children.