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

Freeman Chabala, Mutinta Madubasi, Mable Mwale Mutengo, Njeleka Banda, Kaunda Yamba and Patrick Kaonga
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Freeman Chabala: The Institute of Basic and Biomedical Sciences, Levy Mwanawasa Medical University, Lusaka 10101, Zambia
Mutinta Madubasi: Department of Applied Sciences, Lusaka Apex Medical University, Lusaka 10101, Zambia
Mable Mwale Mutengo: The Institute of Basic and Biomedical Sciences, Levy Mwanawasa Medical University, Lusaka 10101, Zambia
Njeleka Banda: Department of Pathology and Microbiology, School of Medicine, University of Teaching Hospital, Lusaka 10101, Zambia
Kaunda Yamba: Department of Pathology and Microbiology, School of Medicine, University of Teaching Hospital, Lusaka 10101, Zambia
Patrick Kaonga: Tropical Gastroenterology and Nutrition Group, University Teaching Hospital, Lusaka 10101, Zambia

IJERPH, 2020, vol. 17, issue 10, 1-10

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.

Keywords: Escherichia coli; antimicrobial susceptibility; Human Immunodeficiency Virus; bacterial gastroenteritis; Zambia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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