Escherichia coli Antimicrobial Susceptibility Reduction amongst HIV-Infected Individuals at the University Teaching Hospital, Lusaka, Zambia

Abstract

Increased antimicrobial resistance among Human Immunodeficiency Virus (HIV)-infected individuals to commonly used antibiotics in the treatment of gastroenteritis is a public health concern, especially in resource-limited settings. We set out to compare the antimicrobial susceptibility pattern of Escherichia coli (E. coli) isolates from HIV-infected and HIV-uninfected individuals at a tertiary hospital in Lusaka, Zambia. An analytical cross-sectional study was conducted at the University Teaching Hospital from May 2019 to August 2019. Stool samples were screened, and 79 HIV-infected individuals matched by age and sex with 84 HIV-uninfected individuals that presented with E. coli associated gastroenteritis were studied. Demographics were collected from the Laboratory Information System (LIS) and stool samples were collected in a sterile leak-proof container. Samples were cultured and only those where E. coli was isolated were included in the study and tested for antimicrobial susceptibility by the Kirby–Bauer disk diffusion technique. HIV-positive individuals were 3 times (adjusted odds ratio (AOR) = 3.17; 95% CI (1.51, 6.66); p < 0.001) more likely to be resistant to quinolones compared with their HIV-negative counterparts. Similarly, HIV-positive individuals were almost 4 times (AOR = 3.97, 95% CI (1.37, 11.46); p = 0.011) more likely to have multidrug-resistant E. coli compared with those who were HIV-negative. HIV infection was associated with reduced E. coli susceptibility to commonly used antibiotics, and most cases showed resistance.

Healthcare Professionals’ Knowledge of Pharmacogenetics and Attitudes Towards Antimicrobial Utilization in Zambia: Implications for a Precision Medicine Approach to Reducing Antimicrobial Resistance

“…Additionally, contrary to previous studies ( Kaonga et al, 2017 ; Chabala et al, 2020 ), we found a male preponderance in this study (61.5%) probably due to the gender disparity that has been reported that women are less likely to participate in science and medicine ( Gayet-Ageron et al, 2019 ). In our study, at least two-thirds of HCPs believed individual variations can lead to different individual experiences with given medicines, similar to other studies ( Mahmutovic et al, 2018 ), which is important in the implementation of any PGx clinical care ( Muzoriana et al, 2017 ).…”

Prognostic model for nephrotoxicity among HIV-positive Zambian adults receiving tenofovir disoproxil fumarate-based antiretroviral therapy

“…We followed patients with preserved kidney function and no known history of diabetes or underlying comorbidities that were initiating TDF-based ART from December 2018 to November 2019 for approximately three months from the day they initiated therapy. Consistent with other studies [41,42], we found a female preponderance in our study probably because females tend to be more willing to participate in studies than males. Compared to baseline, there was a 29 μmol/L increase in serum creatinine concentration observed at 3-months following therapy initiation, consistent with findings that TDF therapy leads to nephrotoxicity and reduced renal function in the first three to six months [27,43].…”

Prevalence of Pathotypes of Escherichia coli in Stools of HIV-Positive Adults Attending a HAART Clinic in IleIfe, Nigeria

“…; DeWitt et al, 2019;Chabala et al, 2020), in this study the prevalence was low in patients that presented with diarrhoea. The observed low prevalence in patients that presented with diarrhoea seem to support the observation ofMedina et al (2010) that prevalence of E. coli was low in patients that adhere to the highly active antiretroviral therapy (HAART).…”