Studies on <I>Streptococcus pneumoniae </I>associated with pulmonary infection among HIV clients attending Aminu Kano Teaching Hospital (AKTH)

Abstract

Respiratory infection is highly prevalent in HIV-infected patients and S. pneumoniae was a leading cause. The aim   of this study was to isolate and identify Streptococcus pneumoniae associated with pulmonary infection among HIV Clients Attending Aminu Kano Teaching Hospital (AKTH). A total of 300 samples comprising   sample from 180 HIV seropositive patients and 120 HIV seronegative patients as a (control) were enrolled in this study.) For the 180 HIV seropositive patients, 105(58.3%) were females, and 75(41.7%) were males. Among the HIV negative subjects 64(53.3%) were males and 56(46.7%) were females. The incident of Streptococcus pneumoniae isolates associated with pneumonia in HIV/AIDS seropositive patients  in relation to age group in this  study showed the higher  prevalence of 15(51.72%),  among the age groups of 30-39, had the highest  of prevalence of 15(51.72%), which occur more  common in HIV infected patients while for HIV seronegative patients age group 10-19  had the highest  incidence of  7(29.17%).Result showed no significant difference in the prevalence of  S .pneumoniae among the HIV seropositive and seronegative patients (P > 0.05) .Antimicrobial susceptibility showed that Ciprofloxacin 25(86.2%), was found to be most active invitro against the isolates followed by Oxacillin 21(72.4%), Augmentin19       (65.5), Chloramphenicol 15(51.7%). Tetracycline, 14(48.3%), Clindamycin 14(48.3) and Erythromycin 10(34.5%). Result showed no significant difference in the levels of antibiotic susceptibilities and resistance observed (p > 0.05). The CD₄ cells counts for the HIV seropositve patients were 161(89.4%) 350 cells/ml and 19(10.6%) <350 cells/m recorded as normal and low respectively. There was significant difference (p <0.05) for  the CD4 cells counts of the study population with the prevalence of Streptococcus pneumoniae isolates among the HIV seropositive patients  (P 0.000 <0.05).  PCR amplification  for Streptococcus pneumoniae penicillin resistance genes showed that Only 2(33.3%)  out of 6  resistant  isolates  possed the pneumococcal pbp2b resistance gene. According to the findings, the pbp2b gene can play a role of fundamentalimportance in the resistance of S. pneumoniae.  Modify heterogeneity in antibiotic use, which several antibiotics are taken in a rotation against taking just 1 antibiotic such that isolates resistant to 1 antibiotic are killed when the subsequent antibiotic is taken.

Keywords: HIV/AIDS,  Streptococcus Pneumoniae, Antibiotic Resistance, Minimal Inhibitory Concentration (MIC), Pbp2b  CD4 cells count.