Lower respiratory tract infections among HIV positive and control group in Nepal

Ojha, Chet Raj; Rijal, Nisha; Khagendra, K. C.; Palpasa, K.; Кансакар, Прасан; Gupta, Birendra Prasad; Shakya, Geeta

doi:10.1007/s13337-015-0254-z

Cited by 19 publications

(32 citation statements)

References 9 publications

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“…of which Candida albicans was the predominant one. The findings of our study are in line with the studies reported from within Nepal (National Public Health Laboratory, Teku, Kathmandu) 11 and Pokhara, Nepal 29 and elsewhere such as Taiwan, 30 Ilorin, Nigeria, 31 Hyderabad, India, 27 Jaipur, Rajasthan, India, 25 Amritsar, India, 32 Visakhapatnam, India, 14 and Kano Metropolis, Northern Nigeria. 33 The significant association between lower CD4 count and the infections by bacteria and fungi has been established previously.…”

Section: Bacterial and Fungal Opportunistic Infections In Hiv Patientssupporting

confidence: 91%

“…26 In this study, the causative agents of LRTIs were fungi (42%), bacteria (24%), and a mix of bacterial and fungal pathogens (10%). The opportunistic bacterial and fungal infections in HIV patients in our study were lower in comparison to other studies reported from Kathmandu valley (46.6% bacterial infection), 11 Hyderabad, India (44.28% bacterial infection), 27 and Jaipur, Rajasthan, India (86.1% fungal infection). 25 A recent study from Nigeria reported 36% fungal infections in HIV-positive patients.…”

Section: Overview Of Findingscontrasting

confidence: 79%

“…Bacteria such as Legionella pneumophila, Mycoplasma pneumoniae and Chlamydia pneumoniae have also been found to cause HIV-associated pneumonia. 11 Opportunistic fungal infections such as mucocutaneous candidiasis, pneumocystis, cryptococcosis, and histoplasmosis are the most common AIDS-defining conditions. Fungi such as Candida albicans, Cryptococcus neoformans, Histoplasma capsulatum, Coccidioides immitis, Aspergillusspp., Blastomyces dermatitidis, Penicillium marneffei, and Sporothrix schenckii can cause pulmonary infections in persons infected with HIV.…”

Section: Introductionmentioning

confidence: 99%

“…For instance, the risk of developing fungal infections of the lower respiratory tract remains higher in people with a CD4 count less than 200 cells/µL. 11 Preventing opportunistic infections by raising the CD4 count through early and sustained adherence to Antiretroviral therapy (ART) is thus critical. 15 Over the last decades, ART has greatly reduced the mortality from AIDS-related OIs including LRTIs, by reducing HIV viral load in the blood and by strengthening the immune response.…”

Section: Introductionmentioning

confidence: 99%

“…Most of the studies from Nepal reported only opportunistic parasitic infections. [16][17][18] Few studies have reported the prevalence of bacterial and fungal opportunistic infections in HIV-infected patients from Tribhuvan University Teaching Hospital, Kathmandu, 19 National Public Health Laboratory, Kathmandu 11 and Manipal Teaching Hospital, Pokhara. 20 However, none of these studies included antimicrobial susceptibility of these opportunistic infections.…”

Section: Introductionmentioning

confidence: 99%

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<p>Opportunistic Respiratory Infections in HIV Patients Attending Sukraraj Tropical and Infectious Diseases Hospital in Kathmandu, Nepal</p>

Kc¹,

Adhikari²,

Bastola³

et al. 2019

HIV

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Introduction: Opportunistic bacterial and fungal infections are the major cause of morbidity and mortality among immune suppressed HIV-positive patients. The main objective of this study was to determine bacterial and fungal organisms causing respiratory infections and their susceptibility to commonly prescribed antimicrobials among HIV patients attending a tertiary infectious disease hospital in Kathmandu. Methods: Sputum samples were collected from the HIV-positive patients attending Sukraraj Tropical and Infectious Disease Hospital (STIDH) from August 2017 to March 2018. A total of 100 sputum samples were cultured on conventional bacterial and fungal culture media. Bacterial and fungal isolates were identified based on their colony characteristics, microscopic morphology and various biochemical tests. Antibiotic susceptibility test (AST) of bacterial isolates was performed by modified Kirby Bauer disc diffusion method. Results: Out of 100 sputum samples cultured, 24% (n=24) showed bacterial growth, 42% (n=42) showed fungal growth and 10% (n=10) had both bacterial and fungal growth. Among bacteria, 91.6% (n=22) were monomicrobial and 8.4% (n=2) were polymicrobial in growth, of which, Klebsiella pneumoniae (37.5%) were predominant isolates, followed by Pseudomonas aeruginosa (29.2%), and Escherichia coli (16.7%). The antibiotic susceptibility test (AST) showed 68% (17/25) of bacterial isolates were multi-drug resistant (MDR) and among them 41.2% (7/17) were found to be extended spectrum β lactamase (ESBL) producers. Fungal growth was observed in 42% of samples (42/100). A total of six different species of Candida and four different genera of molds were identified. On species differentiation, Candida albicans (20%) were followed by Candida parapsilosis (4%), and Candida dubliniensis (3%); and various molds were Aspergillus fumigatus (4%), Aspergillus flavus (2%), and Penicillium species (5%). CD4 count was inversely associated with bacterial and fungal infections. Fifty percent of the patients with the fungal infections had a CD4 count below 200. No fungal organisms were isolated from HIV-positive patients under antifungal drug treatment. Conclusion: HIV-positive patients with a CD4 count less than 200 cells/µL are more vulnerable to opportunistic infections of bacterial and fungal origin. Early isolation, identification and appropriate treatment can reduce mortality due to co-infections. Routine screening of opportunistic pathogens is critical to contain the disease progression.

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Section: Bacterial and Fungal Opportunistic Infections In Hiv Patientssupporting

confidence: 91%

Section: Overview Of Findingscontrasting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

<p>Opportunistic Respiratory Infections in HIV Patients Attending Sukraraj Tropical and Infectious Diseases Hospital in Kathmandu, Nepal</p>

Kc¹,

Adhikari²,

Bastola³

et al. 2019

HIV

View full text Add to dashboard Cite

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Next-generation sequencing identification of pathogenic bacterial genes and their relationship with fecal indicator bacteria in different water sources in the Kathmandu Valley, Nepal

Shrestha

Tanaka

Malla

et al. 2017

Science of The Total Environment

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Bacterial Infection and Antibiotic Resistance in Patients With Human Immunodeficiency Virus Presenting Lower Respiratory Tract Infection in Nigeria

Bolaji

Onaolapo

Abah

et al. 2021

Preprint

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Lower Respiratory Tract Infection (LRTI) is associated with mortality and prolonged antibiotics use among HIV/AIDS patients. Sputum samples were collected from 134 HIV/AIDS patients with LRTI and productive cough, visiting University of Abuja Teaching Hospital, Nigeria, to determine the bacterial aetiologies and antibiotic resistance profile. Adequate for culture sputum samples were observed in only 119 subjects (75 females and 44 males) and cultured using standard procedure. Isolates were identified by biochemical method and 16SrRNA gene amplification, purification, sequencing and database nucleotide blast. Antibiotic susceptibility tests were performed and interpreted according to Clinical and Laboratory Standard Institute (CLSI) procedures. Bacteria associated LRTI was found in 20.2% of the patients and Klebsiella pneumonia (29.7%); Enterobacter cloacae (16.7%); Enterobacter hormaechei subsp. xiangfangensis (12.5%); Pseudomonas parafulva; Pseudomonas aeruginosa; Pseudomonas alcaliphila; Klebsiella aerogenes (8.3%); Comamonas testosteroni; Escherichia coli; Acinetobacter junii; Acinetobacter soli and Acinetobacter baumannii were implicated. Isolates show high resistance to amoxicillin-clavulanic acid at 94.1%, trimethoprim-sulfamethoxazole at 75.0% and cefotaxime at 70.0%. The Multiple Antibiotic Resistance (MAR) index of most isolates (62.5%) is within 0.3-0.8 in a range of 0.0 to 0.8. Isolates of the same species were found to have different MAR index in different patients. However, E. cloacae, E. hormaechei subsp. xiangfangensis, A. baumanni and 71.4% of K. pneumonia were Multi-drug Resistant (MDR). Interestingly, Gentamycin, Ciprofloxacin and Imipenem were effective against MDR isolates and showed significant negative correlation with MAR index. We propose that antibiotics with efficacy against MDR isolates could be used to down regulate the selective pressure of other antibiotics, and these MDR pathogens, including those rarely associated with human infection poses potential threat, similar to Methicillin Resistant Staphylococcus aureus (MRSA). Particularly, among the immunocompromised. Furthermore, HIV/AIDS patients present good metrics for profiling the burden and spread of antibiotic resistant bacteria in poor countries.

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Lower respiratory tract infections among HIV positive and control group in Nepal

Abstract: Lower respiratory tract infections (LRTIs)

Cited by 19 publications

References 9 publications

<p>Opportunistic Respiratory Infections in HIV Patients Attending Sukraraj Tropical and Infectious Diseases Hospital in Kathmandu, Nepal</p>

<p>Opportunistic Respiratory Infections in HIV Patients Attending Sukraraj Tropical and Infectious Diseases Hospital in Kathmandu, Nepal</p>

Next-generation sequencing identification of pathogenic bacterial genes and their relationship with fecal indicator bacteria in different water sources in the Kathmandu Valley, Nepal

Bacterial Infection and Antibiotic Resistance in Patients With Human Immunodeficiency Virus Presenting Lower Respiratory Tract Infection in Nigeria

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