High co-trimoxazole resistance by bacteria associated with oral lesions in a population of Ugandan HIV-infected and AIDS patients

Abstract number: R2292

Agwu E., Ihongbe J.C., Pazos V.

Objective: Opportunistic infections continue to cause a significant amount of morbidity and mortality in sub-Sahara African patients infected with HIV. This study was designed to assess the effect of prolonged routine cotrimoxazole prophylaxis on bacteria isolated from oral lesions in a population of HIV/AIDS patients in South Western Uganda.

Methods: Exactly 605 swabs (469 from females and 136 from males), were randomly collected from oral lesions of The AIDS Support Organization (TASO) HIV/AIDS patients in 4 Districts (Masaka-142, Rukungiri-152, Bushenyi with Mbarara-305) of Uganda. Sample processing for isolation, identification and antibiogram of bacteria was done aseptically using standard Microbiological techniques. Randomized Block Design (RBD; alpha = 0.05) was used to compare both the prevalence and resistance of each bacterium between districts and bacteria within districts.

Results: Overall bacteria prevalence was highest in Mbarara/Bushenyi (50.4%) followed by Rukungiri (20.8%) and Masaka (20.3%). Between Districts, Streptococcus mutans (30.9%) from Mbarara/Bushenyi were the most predominant bacteria followed by Proteus mirabilis (16.4%) from Rukungiri. Within Districts, Streptococcus mutans (31.7%) from Masaka were the most prevalent followed by: S. aureus (11.3%). In Rukungiri, Streptococcus mutans (22.4%) was the most prevalent followed by Proteus mirabilis (16.4%). In Mbarara/Bushenyi, S. mutans (31.5%) was the most prevalent followed by: S. aureus (11.5%). Within districts, all bacteria isolates from Rukungiri were resistant (100%) to cotrimoxazole except Branhamella catarrhalis which showed (77.8%) resistance. In Mbarara/Bushenyi, the most resistant strains (100%) were S. aureus, B. catarrhalis and Non-haemolytic Streptococcus, followed by Klebsiella pneumoniae (84.6%). Absolute bacterial resistance (100%) in Masaka, were observed in 4 strains: B. cerius, S. aureus, E. coli and B. subtilis. There was a significant difference (p < 0.05) when the prevalence of different bacteria strains in the oral mucosa were compared within districts and between districts. There existed significant difference (p < 0.05) in the effect of the antibiotics when compared between different bacteria and within each bacterium

Conclusion: Prolonged use of cotrimoxazole prophylaxis could be associated with observed cotrimoxazole resistance by our bacteria isolates and could explain observed rebound of oral lesions with bacteria aetiology in the studied population.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Location: Barcelona, Spain
Presentation type:
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