Bacterial bloodstream infections in HIV-infected adults attending a Lagos teaching hospital.
An investigation was carried out during October 2005-September 2006 to determine the prevalence of bloodstream infections in patients attending the outpatient department of the HIV/AIDS clinic at the Lagos University Teaching Hospital in Nigeria. Two hundred and one patients--86 males and 115 females--aged 14-65 years were recruited for the study. Serological diagnosis was carried out on them to confirm their HIV status. Their CD4 counts were done using the micromagnetic bead method. Twenty mL of venous blood sample collected from each patient was inoculated into a pair of Oxoid Signal blood culture bottles for 2-14 days. Thereafter, 0.1 mL of the sample was plated in duplicates on MacConkey, blood and chocolate agar media and incubated at 37 degrees C for 18-24 hours. The CD4+ counts were generally low as 67% of 140 patients sampled had < 200 cells/microL of blood. Twenty-six bacterial isolates were obtained from the blood samples and comprised 15 (58%) coagulase-negative staphylococci as follows: Staphylococcus epidermidis (7), S. cohnii cohnii (1), S. cohnii urealyticum (2), S. chromogenes (1), S. warneri (2), S. scuri (1), and S. xylosus (1). Others were 6 (23%) Gram-negative non-typhoid Salmonella spp., S. Typhimurium (4), S. Enteritidis (2); Pseudomonas fluorescens (1), Escherichia coli (1), Ochrobactrum anthropi (1), Moraxella sp. (1), and Chryseobacterium meningosepticum. Results of antimicrobial susceptibility tests showed that coagulase-negative staphylococci had good sensitivities to vancomycin and most other antibiotics screened but were resistant mainly to ampicilin and tetracycline. The Gram-negative organisms isolated also showed resistance to ampicillin, tetracycline, chloramphenicol, and septrin. This study demonstrates that coagulase-negative staphylococci and non-typhoidal Salmonellae are the most common aetiological agents of bacteraemia among HIV-infected adults attending the Lagos University Teaching Hospital, Nigeria. The organisms were resistant to older-generation antibiotics often prescribed in this environment but were sensitive to vancomycin, cefotaxime, cefuroxime, and other new-generation antibiotics.
Adeyemi
Adeleye I
AI
Department of Microbiology, Faculty of Science, University of Lagos, Akoka, Nigeria. adeyemi21@yahoo.com
Sulaiman
Akanmu A
AA
Solomon
Bamiro B
BB
Chinedu
Obosi A
OA
Victor
Inem A
IA
D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications*; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D015995:Prevalence; D055815:Young Adult
J Chemother. 2000 Oct;12(5):406-11
11128560
Eur J Epidemiol. 2000 Feb;16(2):111-8
10845259
J Infect Dis. 1991 Jul;164(1):81-7
2056220
Clin Infect Dis. 2009 Aug 15;49(4):606-11
19591599
AIDS Patient Care STDS. 2002 Jun;16(6):247-50
12133259
West Indian Med J. 2008 Nov;57(5):519-20
19565989
J Med Microbiol. 2000 Nov;49(11):947-967
11073149
Clin Infect Dis. 1999 Mar;28(3):692-4
10194107
East Afr Med J. 1993 May;70(5):259-62
8306898
Eur J Clin Microbiol Infect Dis. 1995 Oct;14(10):904-8
8605905
J Microbiol Immunol Infect. 2008 Apr;41(2):137-44
18473101
Ann Hematol. 2008 Sep;87(9):771-2
18386007
Emerg Infect Dis. 2000 Sep-Oct;6(5):481-6
10998378
J Chemother. 1998 Jun;10(3):243-7
9669651
BMC Infect Dis. 2001;1:13
11602019
Emerg Infect Dis. 2002 Feb;8(2):220-1
11897080
J Med Microbiol. 2006 May;55(Pt 5):585-591
16585646
BMC Infect Dis. 2006 Jul 28;6:125
16875502
Afr J Med Med Sci. 1998 Sep-Dec;27(3-4):147-51
10497636
West Indian Med J. 2008 Nov;57(5):497-9
19565983
Niger Postgrad Med J. 2009 Sep;16(3):186-92
19767904
J Infect Dis. 2000 Apr;181(4):1414-20
10762572