The common enteric bacterial pathogens and their antimicrobial susceptibility pattern among HIV-infected individuals attending the antiretroviral therapy clinic of Hawassa university hospital, southern Ethiopia

Ayele Kebede,Techalew Shimelis,Solomon Aragie

doi:10.1186/s13756-017-0288-7

Abstract

BackgroundThe frequent occurrence of bacterial gastroenteritis among HIV-infected individuals together with increased antimicrobial drug resistance pose a significant public health challenge in developing countries. This study aimed to determine the prevalence of enteric bacterial pathogens and their antimicrobial susceptibility pattern among HIV-infected patients in a tertiary hospital in southern Ethiopia.MethodsA hospital-based cross-sectional study was conducted at Hawassa University Comprehensive Specialized Hospital from February to May, 2016. A consecutive 215 HIV-infected patients, with complaints of gastrointestinal tract disease, were enrolled. Data on socio-demography and related factors was collected using a structured questionnaire. A stool sample was collected from each study participant and cultured to isolate enteric bacterial pathogens; isolates were characterized using biochemical tests. Antimicrobial susceptibility was determined using the Kirby- Bauer disk diffusion technique.ResultsOut of 215 patients, 27(12.6%) were culture positive for various bacterial pathogens. Campylobacter species was the most common bacterial isolate (6.04%), followed by Salmonella species (5.1%). The majority of isolates was sensitive to norfloxacin, nalidixic acid, gentamicin, ceftriaxone and ciprofloxacin and showed resistance to trimethoprim sulfamethoxazole (SXT) and chloramphenicol. Consumption of raw food was the only risk factor found to be significantly associated with enteric bacterial infection (crude odds ratio 3.41 95% CI 1.13–10.3).ConclusionsThe observed rate of enteric bacterial pathogens and their antimicrobial resistance pattern to the commonly prescribed antibiotics highlights the need to strengthen intervention efforts and promote rational use of antimicrobials. In this regard, the need to strengthen antimicrobial stewardship efforts should be emphasized to slow grown antimicrobial resistance among this population group.

Highlights

The frequent occurrence of bacterial gastroenteritis among Human immunodeficiency virus (HIV)-infected individuals together with increased antimicrobial drug resistance pose a significant public health challenge in developing countries
The present study aimed to identify bacterial pathogens and their antibiotic susceptibility pattern among HIV-infected patients attending a largest hospital in southern Ethiopia
Participants’ socio-demographic and clinical profile A total of 215 HIV-infected individuals were enrolled in this study

Summary

Introduction

The frequent occurrence of bacterial gastroenteritis among HIV-infected individuals together with increased antimicrobial drug resistance pose a significant public health challenge in developing countries. Human immunodeficiency virus (HIV) associated immunosuppression increases the vulnerability of patients to various infections [1]. Enteric bacterial pathogens such as Salmonella species, Campylobacter species, Shigella species, Clostridium difficile and different strains of Escherichia coli have been identified as etiologic agents with the potential to cause severe illness in HIV-infected patients [2, 3]. Several reports from developed countries have shown the decline in diarrheal episodes ( bacterial diarrhea) [4, 6] These protective roles of HAART were not demonstrated in some other studies [3, 8]

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