The human immunodeficiency virus (HIV) was first detected in 1982 among homosexual men, and subsequently, it was further detected in various regions of world. In 2016, WHO estimated that 36.7 million people were living with HIV, 1.9 million were newly infected HIV patients and approximately 1 million people died worldwide. HIV attacks CD4 T cells and causes immunodeficiency. Weakened immune system of HIV patients increases the opportunity to acquire various infections caused by fungi, bacteria, parasites and other viruses. Bacterial infections that cause huge threats to HIV patients are tuberculosis, syphilis, bacterial enteric diseases and bacterial pneumonia. Important bacterial etiologies are Streptococcus pneumoniae, Salmonella spp. Haemophilus influenzae, Staphylococcus aureus, Citrobacter freundii, Escherichia coli, Klebsiella pneumoniae, Morganella morganii, Pseudomonas aeruginosa and Mycobacterium tuberculosis. Frequent bacterial infections in HIV patients increase the usage and also highly expose bacteria to antibiotics. Most problematic multidrug-resistant bacteria are extended-spectrum β-lactamases producing P. aeruginosa, Acinetobacter baumannii, E. coli and K. pneumoniae; vancomycin-resistant enterococci; methicillin-resistant S. aureus and multidrug-resistant and extensively drug-resistant M. tuberculosis. These antibiotic-resistant bacteria complicate the treatment of infections in HIV patients with available antibiotics and sometimes cause death. It also causes higher medical costs, prolonged hospital stays, increased mortality and economic burden on families and societies.
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