Mitiku Asaye, Solomon Zerihin, Gidisa Berhanu, Gebeyhu Kasie, Tewabe Haymanot, Shenkute Demissew, Kassa Melkayehu, Gize Addisu
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Infect Drug Resist. 2023 Jun 29;16:4227-4236. doi: 10.2147/IDR.S410759. eCollection 2023.
In people with human immunodeficiency virus infection, diarrhea is reportedly associated with significant morbidity and mortality. Therefore, the aim of this study was to determine the prevalence, antibiotic susceptibility pattern, and associated factors of enteric bacterial pathogens among HIV infected patients with diarrhea attending the antiretroviral treatment (ART) clinic of Dilla University Referral Hospital, southern Ethiopia.
This institutional-based cross-sectional study was conducted on 422 study participants attending at ART clinic of Dilla University Referral Hospital from March to August 2022. Demographic and clinical data were collected by using a semi-structured questionnaire. Stool specimens were inoculated on selective media like Butzller's medium and Xylose Lysine Deoxycholate (XLD) agar. Antimicrobial resistance pattern was assessed by using Kirby-Bauer disk diffusion techniques. Adjusted odds ratio (AOR) and 95% Confidence Interval (CI) was used to determine the presence of association.
A total of 422 adult patients were enrolled in this study, 51.7% were females. The mean age of the study participants was 27.4 (±15.6 SD) years. The overall prevalence of enteric pathogens was 14.7% (95% CI=11.4-18.2). was the most prevalent organism. Being a farmer (AOR=5.1; 95% CI=1.4-19.1; <0.015), the habit of hand washing after toilet (AOR=1.9; 95% CI=1.02-3.47; <0.04), low CD cell count of <200 cells (AOR=2.22; 95% CI=1.15-4.27; <0.02), and longer duration of diarrhea (AOR=2.68; 95% CI=1.23-5.85; <0.01) were statistically associated. In total, 98.4% of enteric bacterial isolates were sensitive for Meropenem, whereas 82.5% were resistant against Ampicillin. Multidrug resistance was detected in 49.2% of enteric bacteria.
We found that enteric bacteria are common causative agents of diarrhea in immune-compromised patients. The high rate of drug resistance calls for escalating antimicrobial susceptibility testing before prescribing antimicrobial agent.
据报道，在感染人类免疫缺陷病毒的人群中，腹泻与显著的发病率和死亡率相关。因此，本研究的目的是确定在埃塞俄比亚南部迪拉大学转诊医院抗逆转录病毒治疗（ART）门诊就诊的腹泻艾滋病毒感染患者中肠道细菌病原体的患病率、抗生素敏感性模式及相关因素。
本基于机构的横断面研究于2022年3月至8月对迪拉大学转诊医院ART门诊的422名研究参与者进行。使用半结构化问卷收集人口统计学和临床数据。粪便标本接种在选择性培养基上，如布茨勒培养基和木糖赖氨酸脱氧胆酸盐（XLD）琼脂。采用 Kirby-Bauer 纸片扩散技术评估抗菌药物耐药模式。使用调整后的优势比（AOR）和95%置信区间（CI）来确定关联的存在。
本研究共纳入422名成年患者，其中51.7%为女性。研究参与者的平均年龄为27.4（±15.6标准差）岁。肠道病原体的总体患病率为14.7%（95%CI = 11.4 - 18.2）。 是最常见的病原体。职业为农民（AOR = 5.1；95%CI = 1.4 - 19.1；<0.015）、便后洗手习惯（AOR = 1.9；95%CI = 1.02 - 3.47；<0.04）、CD细胞计数低于200个细胞（AOR = 2.22；95%CI = 1.15 - 4.27；<0.02）以及腹泻持续时间较长（AOR = 2.68；95%CI = 1.23 - 5.85；<0.01）在统计学上具有相关性。总共98.4%的肠道细菌分离株对美罗培南敏感，而82.5%对氨苄西林耐药。49.2%的肠道细菌检测到多重耐药。
我们发现肠道细菌是免疫功能低下患者腹泻的常见病原体。高耐药率要求在开具抗菌药物之前加强抗菌药物敏感性检测。
