The isolation rate of Pseudomonas aeruginosa opportunistic pathogen and their antimicrobial responses in HIV-1 positive and negative diarrhoea patients at north-west Part of Ethiopia

Abstract

Background: Pseudomonas aeruginosa is an opportunistic pathogen in immune-compromised patients. However, reports of infections of Pseudomonas aeruginosa were limited in patients infected with HIV. The aim of the study was to determine the frequency of isolation and sensitivity pattern of P. aeruginosa against the commonly used antibiotics in HIV-1 positive and negative diarrheic patients. Methods: Laboratory based cross-sectional study of 312 (199 HIV seropositive and 113 HIV seronegative) diarrheic patients of both genders were investigated at University of Gondar Hospital, Gondar, Ethiopia. P. aeruginosa isolates were isolated from diarrheic stool and identified as per standard methods and tested for antimicrobial susceptibility. Result: Pseudomonas aeruginosa was isolated from 29.5% (92/312) of diarrheic patients, of which 20.5% were from HIV positive subjects. Out of 58 H. zoster positive diarrhoea patients, 47 (81%) were HIV positive and 11 (19%) were HIV seronegative (P < 0.002). The proportion of patients with weight loss and P. aeruginosa infection was significantly higher in those with HIV co-infection (P < 0.05). Among P. aeruginosa isolates 96.4%, 78.6%, 73.2%, 71.4%, 68.8% and 62.5% were sensitive to polymyxin B, gentamycin, norfloxacin, kanamycin, ciprofloxacin and nalidixic acid, respectively. The highest resistance observed was against ampicillin (96.4%), tetracycline (92%), trimethoprim-sulphamethoxazole (89.3%) and chloramphenicol (74.1%). One hundred nine (97.3%) out of the 112 P. aeruginosa isolates were found to be multiple drug resistant. Conclusion: Though high proportion of P. aeruginosa strains were reported in HIV seropositive diarrheic patients, detailed investigation is important to get comprehensive information for better treatment of diarrhoea in HIV /AIDS patients. In this study, ampicillin, tetracycline, trimethoprim-sulphamethoxazole and chloramphenicol may not be used for the treatment of P. aeruginosa infection, unless culture and sensitivity tests are done prior to treatment. Effective public health measures such as prevention of infections through quality environmental sanitation and personal hygiene should be emphasized. © 2012 Andualem B.