Species, Risk Factors, and Antimicrobial Susceptibility Profiles of Bacterial Isolates from HIV-Infected Patients Suspected to Have Pneumonia in Mekelle Zone, Tigray, Northern Ethiopia

Gebre Adhanom, Dawit Gebreegziabiher, Yemane Weldu, Araya Gebreyesus Wasihun, Tadele Araya, Haftom Legese, Bruno S. Lopes, Muthupandian Saravanan (Corresponding Author)

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Abstract

Background. Pneumonia is a condition, where bacterial infections are implicated as the most common causes of morbidity and mortality in humans. The actual burden of HIV-infected patients with pneumonia is not well documented in Mekelle region of Ethiopia. This study estimated the prevalence of bacterial pneumonia in HIV patients, antimicrobial susceptibility patterns of pathogens implicated in pneumonia, and associated risk factors in Mekelle zone, Tigray, Northern Ethiopia, during August-December 2016. Methods. Sputum specimens were collected from 252 HIV seropositive individuals with suspected pneumonia. Data on sociodemographics and risk factors were also collected using a structured questionnaire. Blood, Chocolate, and Mac Conkey agar plates (Oxoid, Hampshire, UK) were used to grow the isolates. The isolated colonies were identified based on Gram stain, colony morphology, pigmentation, hemolysis, and biochemical tests. The antimicrobial susceptibility test was performed using the modified Kirby-Bauer disc diffusion method. The analysis was performed using SPSS version 22 and p-value < 0.05 with corresponding 95% confidence interval (CI) was considered statistically significant. Results. Out of the 252 samples, 110 (43.7%) were positive for various bacterial species. The predominant bacterial species were Klebsiella pneumoniae (n=26, 23.6 %) followed by Streptococcus pneumoniae (n=17, 15.5 %), Escherichia coli (n=16, 14.5%), Klebsiella spp. (n=15, 13.6%), Staphylococcus aureus (n=9, 8.2%), Enterobacter spp. (n=7, 6.3%), Pseudomonas aeruginosa (4, n=3.6%), Proteus spp. (n=4, 3.6%), Citrobacter freundii (n=7, 6.3%), Streptococcus pyogenes (3, 2.7%), and Haemophilus influenzae (n=2, 1.8%). Young age (18-29), recent CD4+ count less than 350 cells/mL, alcohol consumption, and HIV WHO stage II showed significant association with the occurrence of bacterial pneumonia. Resistance to penicillin, co-trimoxazole, and tetracycline was observed in 81.8%, 39.8%, and 24.5% of the isolates, respectively. Conclusions. The problem of pneumonia among HIV patients was significant in the study area. The high prevalence of drug-resistant bacteria isolated from the patient’s samples possesses a health risk in immunocompromised HIV patients. There is a need to strengthen and expand culture and susceptibility procedures for the administration of appropriate therapy to improve patients management and care which may aid in decreasing the mortality.
Original languageEnglish
Article number8768439
Number of pages9
JournalBioMed Research International
Volume2019
DOIs
Publication statusPublished - 5 May 2019

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Ethiopia
Pneumonia
HIV
Health risks
Sulfamethoxazole Drug Combination Trimethoprim
Pathogens
Tetracycline
Penicillins
Escherichia coli
Agar
Bacterial Pneumonia
Bacteria
Blood
Alcohols
Disk Diffusion Antimicrobial Tests
Patient Care Management
Pharmaceutical Preparations
Citrobacter freundii
Penicillin Resistance
Enterobacter

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

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Species, Risk Factors, and Antimicrobial Susceptibility Profiles of Bacterial Isolates from HIV-Infected Patients Suspected to Have Pneumonia in Mekelle Zone, Tigray, Northern Ethiopia. / Adhanom, Gebre; Gebreegziabiher, Dawit; Weldu, Yemane; Wasihun, Araya Gebreyesus; Araya, Tadele; Legese, Haftom; Lopes, Bruno S.; Saravanan, Muthupandian (Corresponding Author).

In: BioMed Research International , Vol. 2019, 8768439, 05.05.2019.

Research output: Contribution to journal › Article

Adhanom, G, Gebreegziabiher, D, Weldu, Y, Wasihun, AG, Araya, T, Legese, H, Lopes, BS & Saravanan, M 2019, 'Species, Risk Factors, and Antimicrobial Susceptibility Profiles of Bacterial Isolates from HIV-Infected Patients Suspected to Have Pneumonia in Mekelle Zone, Tigray, Northern Ethiopia', BioMed Research International , vol. 2019, 8768439. https://doi.org/10.1155/2019/8768439
Adhanom G, Gebreegziabiher D, Weldu Y, Wasihun AG, Araya T, Legese H et al. Species, Risk Factors, and Antimicrobial Susceptibility Profiles of Bacterial Isolates from HIV-Infected Patients Suspected to Have Pneumonia in Mekelle Zone, Tigray, Northern Ethiopia. BioMed Research International . 2019 May 5;2019. 8768439. https://doi.org/10.1155/2019/8768439
Adhanom, Gebre ; Gebreegziabiher, Dawit ; Weldu, Yemane ; Wasihun, Araya Gebreyesus ; Araya, Tadele ; Legese, Haftom ; Lopes, Bruno S. ; Saravanan, Muthupandian. / Species, Risk Factors, and Antimicrobial Susceptibility Profiles of Bacterial Isolates from HIV-Infected Patients Suspected to Have Pneumonia in Mekelle Zone, Tigray, Northern Ethiopia. In: BioMed Research International . 2019 ; Vol. 2019.
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title = "Species, Risk Factors, and Antimicrobial Susceptibility Profiles of Bacterial Isolates from HIV-Infected Patients Suspected to Have Pneumonia in Mekelle Zone, Tigray, Northern Ethiopia",
abstract = "Background. Pneumonia is a condition, where bacterial infections are implicated as the most common causes of morbidity and mortality in humans. The actual burden of HIV-infected patients with pneumonia is not well documented in Mekelle region of Ethiopia. This study estimated the prevalence of bacterial pneumonia in HIV patients, antimicrobial susceptibility patterns of pathogens implicated in pneumonia, and associated risk factors in Mekelle zone, Tigray, Northern Ethiopia, during August-December 2016. Methods. Sputum specimens were collected from 252 HIV seropositive individuals with suspected pneumonia. Data on sociodemographics and risk factors were also collected using a structured questionnaire. Blood, Chocolate, and Mac Conkey agar plates (Oxoid, Hampshire, UK) were used to grow the isolates. The isolated colonies were identified based on Gram stain, colony morphology, pigmentation, hemolysis, and biochemical tests. The antimicrobial susceptibility test was performed using the modified Kirby-Bauer disc diffusion method. The analysis was performed using SPSS version 22 and p-value < 0.05 with corresponding 95{\%} confidence interval (CI) was considered statistically significant. Results. Out of the 252 samples, 110 (43.7{\%}) were positive for various bacterial species. The predominant bacterial species were Klebsiella pneumoniae (n=26, 23.6 {\%}) followed by Streptococcus pneumoniae (n=17, 15.5 {\%}), Escherichia coli (n=16, 14.5{\%}), Klebsiella spp. (n=15, 13.6{\%}), Staphylococcus aureus (n=9, 8.2{\%}), Enterobacter spp. (n=7, 6.3{\%}), Pseudomonas aeruginosa (4, n=3.6{\%}), Proteus spp. (n=4, 3.6{\%}), Citrobacter freundii (n=7, 6.3{\%}), Streptococcus pyogenes (3, 2.7{\%}), and Haemophilus influenzae (n=2, 1.8{\%}). Young age (18-29), recent CD4+ count less than 350 cells/mL, alcohol consumption, and HIV WHO stage II showed significant association with the occurrence of bacterial pneumonia. Resistance to penicillin, co-trimoxazole, and tetracycline was observed in 81.8{\%}, 39.8{\%}, and 24.5{\%} of the isolates, respectively. Conclusions. The problem of pneumonia among HIV patients was significant in the study area. The high prevalence of drug-resistant bacteria isolated from the patient’s samples possesses a health risk in immunocompromised HIV patients. There is a need to strengthen and expand culture and susceptibility procedures for the administration of appropriate therapy to improve patients management and care which may aid in decreasing the mortality.",
author = "Gebre Adhanom and Dawit Gebreegziabiher and Yemane Weldu and Wasihun, {Araya Gebreyesus} and Tadele Araya and Haftom Legese and Lopes, {Bruno S.} and Muthupandian Saravanan",
note = "Data Availability Data supporting the conclusions of this article are available by request from G. Adhanom. The relevant raw data will be made available to researchers wishing to use them for noncommercial purposes. Acknowledgments The authors would like to acknowledge Mekelle University for financing and allowing the laboratory space and materials to conduct the laboratory work. All ART clinics of Mekelle zone and all study participants are acknowledged for their willingness to participate in this study. This work was supported by Mekelle University, College of Health Sciences, Postgraduate Students Research fund.",
year = "2019",
month = "5",
day = "5",
doi = "10.1155/2019/8768439",
language = "English",
volume = "2019",
journal = "BioMed Research International",
issn = "2314-6133",
publisher = "Hindawi Publishing Corporation",

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TY - JOUR

T1 - Species, Risk Factors, and Antimicrobial Susceptibility Profiles of Bacterial Isolates from HIV-Infected Patients Suspected to Have Pneumonia in Mekelle Zone, Tigray, Northern Ethiopia

AU - Adhanom, Gebre

AU - Gebreegziabiher, Dawit

AU - Weldu, Yemane

AU - Wasihun, Araya Gebreyesus

AU - Araya, Tadele

AU - Legese, Haftom

AU - Lopes, Bruno S.

AU - Saravanan, Muthupandian

N1 - Data Availability Data supporting the conclusions of this article are available by request from G. Adhanom. The relevant raw data will be made available to researchers wishing to use them for noncommercial purposes. Acknowledgments The authors would like to acknowledge Mekelle University for financing and allowing the laboratory space and materials to conduct the laboratory work. All ART clinics of Mekelle zone and all study participants are acknowledged for their willingness to participate in this study. This work was supported by Mekelle University, College of Health Sciences, Postgraduate Students Research fund.

PY - 2019/5/5

Y1 - 2019/5/5

N2 - Background. Pneumonia is a condition, where bacterial infections are implicated as the most common causes of morbidity and mortality in humans. The actual burden of HIV-infected patients with pneumonia is not well documented in Mekelle region of Ethiopia. This study estimated the prevalence of bacterial pneumonia in HIV patients, antimicrobial susceptibility patterns of pathogens implicated in pneumonia, and associated risk factors in Mekelle zone, Tigray, Northern Ethiopia, during August-December 2016. Methods. Sputum specimens were collected from 252 HIV seropositive individuals with suspected pneumonia. Data on sociodemographics and risk factors were also collected using a structured questionnaire. Blood, Chocolate, and Mac Conkey agar plates (Oxoid, Hampshire, UK) were used to grow the isolates. The isolated colonies were identified based on Gram stain, colony morphology, pigmentation, hemolysis, and biochemical tests. The antimicrobial susceptibility test was performed using the modified Kirby-Bauer disc diffusion method. The analysis was performed using SPSS version 22 and p-value < 0.05 with corresponding 95% confidence interval (CI) was considered statistically significant. Results. Out of the 252 samples, 110 (43.7%) were positive for various bacterial species. The predominant bacterial species were Klebsiella pneumoniae (n=26, 23.6 %) followed by Streptococcus pneumoniae (n=17, 15.5 %), Escherichia coli (n=16, 14.5%), Klebsiella spp. (n=15, 13.6%), Staphylococcus aureus (n=9, 8.2%), Enterobacter spp. (n=7, 6.3%), Pseudomonas aeruginosa (4, n=3.6%), Proteus spp. (n=4, 3.6%), Citrobacter freundii (n=7, 6.3%), Streptococcus pyogenes (3, 2.7%), and Haemophilus influenzae (n=2, 1.8%). Young age (18-29), recent CD4+ count less than 350 cells/mL, alcohol consumption, and HIV WHO stage II showed significant association with the occurrence of bacterial pneumonia. Resistance to penicillin, co-trimoxazole, and tetracycline was observed in 81.8%, 39.8%, and 24.5% of the isolates, respectively. Conclusions. The problem of pneumonia among HIV patients was significant in the study area. The high prevalence of drug-resistant bacteria isolated from the patient’s samples possesses a health risk in immunocompromised HIV patients. There is a need to strengthen and expand culture and susceptibility procedures for the administration of appropriate therapy to improve patients management and care which may aid in decreasing the mortality.

AB - Background. Pneumonia is a condition, where bacterial infections are implicated as the most common causes of morbidity and mortality in humans. The actual burden of HIV-infected patients with pneumonia is not well documented in Mekelle region of Ethiopia. This study estimated the prevalence of bacterial pneumonia in HIV patients, antimicrobial susceptibility patterns of pathogens implicated in pneumonia, and associated risk factors in Mekelle zone, Tigray, Northern Ethiopia, during August-December 2016. Methods. Sputum specimens were collected from 252 HIV seropositive individuals with suspected pneumonia. Data on sociodemographics and risk factors were also collected using a structured questionnaire. Blood, Chocolate, and Mac Conkey agar plates (Oxoid, Hampshire, UK) were used to grow the isolates. The isolated colonies were identified based on Gram stain, colony morphology, pigmentation, hemolysis, and biochemical tests. The antimicrobial susceptibility test was performed using the modified Kirby-Bauer disc diffusion method. The analysis was performed using SPSS version 22 and p-value < 0.05 with corresponding 95% confidence interval (CI) was considered statistically significant. Results. Out of the 252 samples, 110 (43.7%) were positive for various bacterial species. The predominant bacterial species were Klebsiella pneumoniae (n=26, 23.6 %) followed by Streptococcus pneumoniae (n=17, 15.5 %), Escherichia coli (n=16, 14.5%), Klebsiella spp. (n=15, 13.6%), Staphylococcus aureus (n=9, 8.2%), Enterobacter spp. (n=7, 6.3%), Pseudomonas aeruginosa (4, n=3.6%), Proteus spp. (n=4, 3.6%), Citrobacter freundii (n=7, 6.3%), Streptococcus pyogenes (3, 2.7%), and Haemophilus influenzae (n=2, 1.8%). Young age (18-29), recent CD4+ count less than 350 cells/mL, alcohol consumption, and HIV WHO stage II showed significant association with the occurrence of bacterial pneumonia. Resistance to penicillin, co-trimoxazole, and tetracycline was observed in 81.8%, 39.8%, and 24.5% of the isolates, respectively. Conclusions. The problem of pneumonia among HIV patients was significant in the study area. The high prevalence of drug-resistant bacteria isolated from the patient’s samples possesses a health risk in immunocompromised HIV patients. There is a need to strengthen and expand culture and susceptibility procedures for the administration of appropriate therapy to improve patients management and care which may aid in decreasing the mortality.

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