Bacterial Profile and their Antibiotic Resistance Pattern among HIV Patients Diagnosed with Pneumonia in Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Abstract

Background: Bacterial pneumonia remains the major cause of morbidity and admission diagnosis among human immunodeficiency virus-infected individuals. In the study area, data about the bacterial profile of pneumonia and their antimicrobial resistance pattern among people living with human immunodeficiency virus is limited. Hence, this study was aimed to estimate the prevalence of bacterial pneumonia, antibiotic resistance patterns of isolated bacteria, and associated factors among HIV patients in Felege Hiwot Referral Hospital. Method: A Hospital-based cross-sectional study was conducted from February 15 to June 15, 2019. Sputum specimens were collected from 163 pneumonia presumptive HIV seropositive individuals. Data on socio-demographic characteristics and risk factors were also collected using a structured questionnaire. Blood, Chocolate, and MacConkey agar plates were used to grow the isolates. The isolated colonies were identified based on Gram Stain, colony morphology, hemolysis, and biochemical tests. The antimicrobial susceptibility test was performed using the modified Kirby-Bauer Disc Diffusion method. Descriptive and multivariate analyses were performed using SPSS version 23. P-value < 0.05 was considered statistically significant. Result: Out of 163 sputum samples, 68 (41.7%) were culture positive for common bacterial infections. The predominant bacterial isolates were Klebsiella pneumoniae 19 (27.9%), and Staphylococcus aureus, 17 (25%). From multivariate analysis, age groups 18-29 (AOR = 5.4, 95 % CI: 1.26-23.35), age groups 30-39 (AOR = 3.8, 95% CI: 1.03 13.80), recent viral load greater than or equal to 150 copies/ml (AOR= 24.3, 95 % CI: 2.61-56.38), viral load less than 150 copies/ml (AOR= 5.1, 95% CI: 1.26-21.04), cigarette smoking (AOR=15.5, 95% CI: 1.61-48.59), and alcohol consumption (AOR=8.1, 95% CI: 2.76-23.51) were found to have statistically significant association with bacterial pneumonia. Out of the tested antibiotics, 46 (70.8%) were resistant to cotrimoxazole and P. aeruginosa were 100% resistant to gentamycin and ceftazidime. Overall, 77.9% of the isolates were MDR. Conclusion: The study showed a high prevalence of bacterial pneumonia and a high percentage of drug resistance including MDR in the study area. Therefore, we recommend that culture and antimicrobial susceptibility tests should be routinely performed for the selection of appropriate treatment.