Bacterial chest infections in HIV-1 positive and negative individuals in rural Uganda; aetiology and antibiotic sensitivity.
Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10228)
Mayanja B, Van der Paal LV, Kigozi B, Eotu H, Whitworth JA Medical Research Council Programme on AIDS-Uganda Virus Research Institute, Entebbe, Uganda
Background Recurrent chest infections are associated with severe HIV disease. Knowledge of the aetiology and antibiotic sensitivity in resource poor countries with limited laboratory facilities is essential to formulate appropriate treatment protocols. Methods Adult participants in a clinical cohort study presenting with a community acquired chest infection provided fresh sputum samples. Microbiological sputum examination and sensitivity testing to commonly available antibiotics was done. Results Out of the 238 participants who provided 948 sputum samples between July 1996 and December 2001, 64.7% were HIV-1 positive. 330 bacterial isolates were recovered from 294 samples. 53% were H.influenzae with sensitivity to chloramphenicol-82%, erythromycin-77%, ampicillin-60% and tetracycline-60%; 32% S.pneumoniae sensitive to erythromycin-98%, chloramphenicol-88%, ampicillin-72% and tetracycline-54% and 7.6% Moraxella catarrhalis sensitive to chloramphenicol-100%, erythromycin-96%, tetracycline-88% and ampicillin-73%. Sensitivity to penicillin for H.influenzae, S.pneumoniae and M.catarrhalis was 48%, 54% and 27% respectively. The pattern of bacterial isolates was not associated with HIV serostatus. Conclusions H. influenzae, S. pneumoniae and M. catarrhalis represented over 90% of the sputum bacterial isolates in this study population. Chloramphenicol, erythromycin and ampicillin had highest antibiotic sensitivity. They can be used for suspected chest infections where laboratory facilities are limited and newer but expensive antibiotics are unavailable or unaffordable like in rural Uganda.
Keywords: AEGIS, Uganda, Anti-Bacterial Agents, Bacterial Infections, Moraxella (Branhamella) catarrhalis, Haemophilus influenzae, Chloramphenicol, Sensitivity and Specificity, Erythromycin, Ampicillin, Ampicillin Resistance, Cohort Studies, Adult
