[1]Obeng-Mensah, D., *[2]Boamah, V. E., 2Boakye, Y. D., and 2Agyare, C.
1Department of Pharmaceutical Microbiology, School of pharmacy and pharmaceutical Sciences, University of Cape Coast, Cape Coast, Ghana
2Pharmaceutical Microbiology, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
*Correspondence to: veboamah.pharm@knust.edu.gh; etsiapa@yahoo.com
Abstract:
Background: Enteric bacterial infections are at least ten times more common in HIV individuals compared to the general population. This results in frequent consumption of antibiotics either for prophylactic or treatment purposes, resulting in a rise in emergence of multidrug-resistant (MDR) bacteria. The paucity of research on antibiotic resistance in enteric bacteria among HIV individuals in secondary and primary healthcare settings in Ghana necessitated this study, which investigated the antibiotic susceptibility and resistance patterns of enteric bacterial isolates from HIV-positive individuals at three healthcare facilities in Kumasi metropolis, Ghana.
Methodology: This was a descriptive cross-sectional survey of 57 HIV-seropositive individuals on anti-retroviral therapy at three selected district hospitals in Kumasi metropolis, for resistance pattern of enteric bacteria. Faecal samples from HIV-positive individuals were collected for microbiological analysis, using differential and selective agar media and conventional biochemical assays for isolation, preliminary characterisation and presumptive identification of bacterial isolates. Confirmatory identification of the isolates was performed using MALDI-TOF MS. Antimicrobial susceptibility testing by the Kirby-Bauer disk diffusion method was used to evaluate the susceptibility of the isolates to a panel of 10 antimicrobial agents. Data were analysed with WHONET software, GraphPad Prism, Microsoft Excel and SPSS. Association of demographic data and other patients’ parameters was determined using Chi-square tests with 95% confidence interval and p<0.05 was considered significant.
Results: Thirty enteric bacterial isolates were confirmed from the 57 HIV-seropositive individuals, comprising predominantly Escherichia coli (80.0%), Klebsiella pneumoniae (10.0%), Enterococcus faecalis (6.7%), and Enterobacter cloacae (3.3%). Antimicrobial susceptibility testing showed resistance rates ranging from 3.3% to 100.0%, with majority of isolates susceptible to ciprofloxacin and meropenem. Sixty per cent of the isolates were MDR and E. coli and K. pneumoniae isolates were highly resistant to amoxicillin-clavulanic acid and ampicillin.
Conclusion: E. coli was the most frequent enteric bacterial isolate carried by HIV-infected individuals in this study. Over 60% of the enteric bacteria were multidrug-resistant. Meropenem and ciprofloxacin were the antibiotics with high invitro inhibitory activity against the isolates. The use of these antibiotics for therapy should however be guarded to avoid rapid resistance development by bacterial pathogens to these agents.
Keywords: HIV seropositive. Enterobacteria, E. coli, meropenem, ciprofloxacin
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