Prevalence and antibiotic resistance pattern of blood culture isolates from human immuno-deficiency virus (HIV) patients on highly active anti-retroviral therapy (HAART) in Nigeria

Bloodstream infections remain public health problem and have resulted to morbidity and mortality in HIV/AIDS patients. This study was therefore aimed at determining the prevalence of bacteremia in HIV infected patients on highly active anti-retroviral therapy (HAART) attending Federal Medical Centre, Ido-Ekiti, Ekiti State. A total of 105 blood samples were cultured using brain heart infusion and subcultured on bismuth sulphite agar, MacConkey agar and chocolate agar. Isolates were identified using cultural and biochemical characterization. Antibiotic susceptibility test was done using disc diffusion method. The prevalence of bloodstream infection in HIV infected patients on HAART was found to be 22.9% and they were having the CD4+ T-cell counts of <300 cells/µl. There were five males and 19 females that had bloodstream bacterial infection. A total number of 24 isolates were recovered with Escherichia coli being the most prevalent bacterial isolates 12(50.0%), followed by Staphylococcus aureus, 8 (33.3%) and Streptococcus pneumoniae, 4 (16.7%). The antibiotic susceptibility test revealed a high level of resistance with highest resistance seen in Cotrimoxazole (87.5%), followed by ciprofloaxcin (83.3%), ampicillin (79.2%), levofloxacin (62.5%) while ceftazidime, ceftriaxone and gentamycin (54.2% each) showed the least resistance. The overall percentage of antibiotics resistance of the 7 selected antibiotics tested against isolated bacterial had 71.4, 67.9 and 66.1% resistance for S. pneumonia, Escherichia coli and S. aureus, respectively. However, the prevalence of bloodstream infection among HIV patients on HAART in Ekiti was relatively high and resistance to cephalosporins drugs was lower as compared to fluoroquinolones. Therefore, cephalosporin group of antibiotics is recommended for the treatment of bacteria bloodstream infection in HIV/AIDS patients.