Ethiop Med J 2002 Oct;40(4):353-64
School of Medical Laboratory Technology, Jimma University, P.O. Box 378, Jimma, Ethiopia.
Diarrhea is a major clinical problem in HIV-infected patients. There is a need to monitor antimicrobial susceptibility patterns of enteric bacterial pathogens in order to ensure appropriate treatment and control of infections. The objectives of this study was to identify and determine the magnitude of potential enteric pathogens including Salmonella, Shigella, Campylobacter and other species in HIV-infected and HIV-non-infected patients with diarrhea, to evaluate the current antimicrobial susceptibility pattern of the clinical isolates and the association of enteric bacterial pathogens in HIV infected patients with diarrhea. A cross-sectional study was conducted from Feb-July 2001 on 372 consecutive HIV seropositive and seronegative patients presenting at Jimma hospital for different illnesses. Patients were selected based on their serological tests for HIV. Sample of faeces specimens were collected and inoculated onto standard culture media as well as onto Skirrow's medium for isolation of Campylobacter species. Salmonella and Shigella species were tested for antimicrobial susceptibility using disc agar diffusion technique recommended by Kirby-Bauer. Stool specimens were also smeared and stained by Zehl-Neelson staining technique for the identification of Mycobacterium species. Among the 99 HIV-infected patients with diarrhea, 25 (25.0%) of them had enteric bacteria among which 8(8.1%) were Salmonella, 4(4.0%) Shigella and 13(13.1%) Campylobacter species. Mycobacterium species were identified in 3(3.0%) of stool specimens obtained from HIV-infected patients with diarrhea and another 3 species were detected in HIV-infected patient without diarrhea. Salmonella species were isolated with higher prevalence in HIV-infected than in HIV non-infected patients. These Salmonella isolates were 100% susceptible to Amikacin, Gentamicin, Nalidixic acid and Kanamycin while Shigella isolates were 100% susceptible for Gentamycin and Kanamycin only. Unlike Salmonella, Shigella and Campylobacter species showed higher prevalence rates in HIV non-infected patients. Enteric bacterial pathogens account for about one fourth diarrhea in HIV infected patients in Jimma hospital. The finding of this investigation also confirmed earlier observations of wide spread resistance to the commonly used drugs in this region.
Download full-text PDF