Prevalence and Antimicrobial Susceptibility Patterns of Salmonella and Shigella in HIV Patients in Ile-Ife, Osun State

Abstract

Introduction: Diarrhoea is a clinical manifestation of HIV/AIDS infected people. These people have increased risk of Non-typhoidal Salmonella (NTS) and Shigella infections compared to immunocompetent people. The goal of this study is to determine the prevalence and antimicrobial susceptibility patterns of Salmonella and Shigella in HIV Seropositive patients. Methods : A total of 150 HIV patients attending Obafemi Awolowo University teaching hospital were enrolled in this study with age range of 18 70 years. Stool samples were collected and cultured on a selective medium for the isolation of Salmonella and Shigella strains. Isolates were subjected to antimicrobial susceptibility testing by disc diffusion method. Interpretation was done based on Clinical and Laboratory Standard Institute criteria. Data was analysed using Statistical package for Social Science. Results : The prevalence of Salmonella and Shigella found in the stool samples examined were found to be 10(6.6%). Salmonella accounted for 2(1.3%). The species consisted of Salmonella enterica serovar Enteritidis (n=2). Shigella accounted for 8(5.3%). Shigella species comprised of S. flexneri (n=7), S. dysenteriae (n=1). All Salmonella and Shigella strains were 100% resistant to Tetracycline and Ampicillin and 100% sensitive to Nitrofurantoin and Ciprofloxacin. It was observed that 90% of all the patients had a CD4 count ? 200 cells/mm³ as a result of the administration of antiretroviral therapy. Conclusion: The high proportion of HIV patients who had diarrhoea in the absence of Salmonella and Shigella strongly indicate that other infectious agent are responsible for diarrhoea like Campylobacter or Escherichia coli especially Diarrhoeagenic Escherichia coli . In the light of this study, Ciprofloxacin and Nitrofurantoin can be best used as empirical treatment prior to diagnosis when life threatening cases are imminent.