Effect of chronic systemic use of trimethoprim-sulfamethoxazole in the conjunctival bacterial flora of patients with HIV infection.
OBJECTIVE
To investigate the effect of orally administered trimethoprim-sulfamethoxazole (TMP-SMZ) on the prevalence, species distribution, and resistance of the conjunctival bacterial flora in adults with human immunodeficiency virus (HIV) infection.


METHODS
Cross-sectional study, with clinical and experimental laboratory investigation.


METHODS
Samples from the inferior conjunctival fornix were collected and submitted for culture to evaluate aerobic flora.


RESULTS
Sixty samples were collected. Negative cultures were found in 17 (56.7%) eyes of the TMP-SMZ group and in 10 (33%) of the control group (P = .036). All Staphylococcus species isolates in the TMP-SMZ group were resistant to the drug, whereas 50% of the control group presented this finding (P = .025). In the study group, all bacteria were resistant to TMP-SMZ, compared with only 47% of the microorganisms in the control group.


CONCLUSIONS
Orally administered TMP-SMZ in patients with HIV infection seems to exert a selection pressure in the microorganisms present on the conjunctiva.
Uveitis and AIDS Sector, Laboratory of External Diseases, Department of Ophthalmology of the Federal University of Sao Paulo/Paulista School of Medicine, Sao Paulo, Brazil. brunofontes@oftalmo.epm.br <brunofontes@oftalmo.epm.br>
Bruno M
BM
Fontes
Cristina
C
Muccioli
André H
AH
Príncipe
Luciana P
LP
Finamor
Ana L
AL
Höfling-Lima
Rubens
R
Belfort
D000284:Administration, Oral; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D003228:Conjunctiva / Q000382:microbiology*; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D015658:HIV Infections / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage*
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination