EFFECT OF TRIMETHOPRIM-SULFAMETHOXAZOLE PROPHYLAXIS ON FAECAL CARRIAGE RATES OF RESISTANT ISOLATES OF ESCHERICHIA COLI IN HIV-INFECTED ADULT PATIENTS IN LAGOS
Identifieur interne : 001100 ( Main/Exploration ); précédent : 001099; suivant : 001101EFFECT OF TRIMETHOPRIM-SULFAMETHOXAZOLE PROPHYLAXIS ON FAECAL CARRIAGE RATES OF RESISTANT ISOLATES OF ESCHERICHIA COLI IN HIV-INFECTED ADULT PATIENTS IN LAGOS
Auteurs : C. C. Egwuatu [Nigeria] ; A. A. Iwuafor [Nigeria] ; T. O. Egwuatu [Nigeria] ; C. N. Akujobi [Nigeria] ; A. U. Nnachi [Nigeria] ; I. N. Aghanya [Nigeria] ; F. T. Ogunsola [Nigeria] ; O. O. Oduyebo [Nigeria]Source :
- African Journal of Infectious Diseases [ 2006-0165 ] ; 2016.
Abstract
The daily use of Trimethoprim-Sulfamethoxazole (TMP-SMX) prophylaxis reduces morbidity and mortality among patients infected with Human Immunodeficiency Virus (HIV) but its impact on increasing antimicrobial resistance rates has been of public concern globally. This study investigated the effect of daily TMP-SMX prophylaxis on faecal carriage rates of resistant isolates of
A total of 550 HIV-infected patients with CD4-cell count of less than 350 cell/mm3 and were eligible for TMP-SMX prophylaxis attending Lagos University Teaching Hospital, Lagos, Nigeria, were recruited. Stool/rectal swab samples were aseptically collected from the patients and processed using standard methods for culture and sensitivity.
There was a baseline Trimethoprim-Sulfamethoxazole resistance rate of 54% which increased to 77.9% in first 3 months, rising to 96.1% by 6 months and all isolates were resistant by the 9th month. There was also evidence of cross-resistance to other antibiotics with significant association with TMP-SMX resistance (p<0.0001). The
The carriage rate of faecal
Url:
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411991
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5349762
DOI: 10.21010/ajid.v10i2.12
PubMed: 28480451
PubMed Central: 5411991
Affiliations:
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Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">EFFECT OF TRIMETHOPRIM-SULFAMETHOXAZOLE PROPHYLAXIS ON FAECAL CARRIAGE RATES OF RESISTANT ISOLATES OF <italic>ESCHERICHIA COLI</italic>
IN HIV-INFECTED ADULT PATIENTS IN LAGOS</title>
<author><name sortKey="Egwuatu, C C" sort="Egwuatu, C C" uniqKey="Egwuatu C" first="C. C." last="Egwuatu">C. C. Egwuatu</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Department of Medical Microbiology and Parasitology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nigeria</nlm:aff>
<country xml:lang="fr">Nigeria</country>
<wicri:regionArea>Department of Medical Microbiology and Parasitology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus</wicri:regionArea>
<wicri:noRegion>Nnewi Campus</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Iwuafor, A A" sort="Iwuafor, A A" uniqKey="Iwuafor A" first="A. A." last="Iwuafor">A. A. Iwuafor</name>
<affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medical Microbiology and Parasitology, Faculty of Medicine and Dentistry, College of Medical Sciences, University of Calabar, Calabar, Nigeria</nlm:aff>
<country xml:lang="fr">Nigeria</country>
<wicri:regionArea>Department of Medical Microbiology and Parasitology, Faculty of Medicine and Dentistry, College of Medical Sciences, University of Calabar, Calabar</wicri:regionArea>
<wicri:noRegion>Calabar</wicri:noRegion>
</affiliation>
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<author><name sortKey="Egwuatu, T O" sort="Egwuatu, T O" uniqKey="Egwuatu T" first="T. O." last="Egwuatu">T. O. Egwuatu</name>
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<country xml:lang="fr">Nigeria</country>
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<wicri:noRegion>University of Lagos</wicri:noRegion>
</affiliation>
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<author><name sortKey="Akujobi, C N" sort="Akujobi, C N" uniqKey="Akujobi C" first="C. N." last="Akujobi">C. N. Akujobi</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Department of Medical Microbiology and Parasitology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nigeria</nlm:aff>
<country xml:lang="fr">Nigeria</country>
<wicri:regionArea>Department of Medical Microbiology and Parasitology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus</wicri:regionArea>
<wicri:noRegion>Nnewi Campus</wicri:noRegion>
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<author><name sortKey="Nnachi, A U" sort="Nnachi, A U" uniqKey="Nnachi A" first="A. U." last="Nnachi">A. U. Nnachi</name>
<affiliation wicri:level="1"><nlm:aff id="aff4">Department of Immunology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nigeria</nlm:aff>
<country xml:lang="fr">Nigeria</country>
<wicri:regionArea>Department of Immunology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus</wicri:regionArea>
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<author><name sortKey="Aghanya, I N" sort="Aghanya, I N" uniqKey="Aghanya I" first="I. N." last="Aghanya">I. N. Aghanya</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Department of Medical Microbiology and Parasitology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nigeria</nlm:aff>
<country xml:lang="fr">Nigeria</country>
<wicri:regionArea>Department of Medical Microbiology and Parasitology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus</wicri:regionArea>
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</affiliation>
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<author><name sortKey="Ogunsola, F T" sort="Ogunsola, F T" uniqKey="Ogunsola F" first="F. T." last="Ogunsola">F. T. Ogunsola</name>
<affiliation wicri:level="1"><nlm:aff id="aff5">Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria</nlm:aff>
<country xml:lang="fr">Nigeria</country>
<wicri:regionArea>Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos</wicri:regionArea>
<wicri:noRegion>University of Lagos</wicri:noRegion>
</affiliation>
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<author><name sortKey="Oduyebo, O O" sort="Oduyebo, O O" uniqKey="Oduyebo O" first="O. O." last="Oduyebo">O. O. Oduyebo</name>
<affiliation wicri:level="1"><nlm:aff id="aff5">Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria</nlm:aff>
<country xml:lang="fr">Nigeria</country>
<wicri:regionArea>Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos</wicri:regionArea>
<wicri:noRegion>University of Lagos</wicri:noRegion>
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</analytic>
<series><title level="j">African Journal of Infectious Diseases</title>
<idno type="ISSN">2006-0165</idno>
<idno type="eISSN">2505-0419</idno>
<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title>
<p>The daily use of Trimethoprim-Sulfamethoxazole (TMP-SMX) prophylaxis reduces morbidity and mortality among patients infected with Human Immunodeficiency Virus (HIV) but its impact on increasing antimicrobial resistance rates has been of public concern globally. This study investigated the effect of daily TMP-SMX prophylaxis on faecal carriage rates of resistant isolates of <italic>Escherichia coli</italic>
in HIV-infected adult patients in Lagos.</p>
</sec>
<sec id="st2"><title>Methods:</title>
<p>A total of 550 HIV-infected patients with CD4-cell count of less than 350 cell/mm<sup>3</sup>
and were eligible for TMP-SMX prophylaxis attending Lagos University Teaching Hospital, Lagos, Nigeria, were recruited. Stool/rectal swab samples were aseptically collected from the patients and processed using standard methods for culture and sensitivity.</p>
</sec>
<sec id="st3"><title>Results:</title>
<p>There was a baseline Trimethoprim-Sulfamethoxazole resistance rate of 54% which increased to 77.9% in first 3 months, rising to 96.1% by 6 months and all isolates were resistant by the 9th month. There was also evidence of cross-resistance to other antibiotics with significant association with TMP-SMX resistance (p<0.0001). The <italic>Escherichia coli</italic>
isolates showed a progressive increase in resistance to the tested antibiotics over the 12-month period. The resistance was in the following order: Ampicillin (74% to 82.6% in the first 3 months; 98.3% by the 6th month and 99.4% by the 9th month; all isolates were resistant by the 12th month). Augmentin (32.5% to 47.7% in first 3 months; 76.1% by the 6th month; 86.3% by the 9th month; all isolates were resistant by 12 months). Ceftriaxone (2.0% to 10.8% in first 3 months; 20.6% by the 6th month; 24.2% by the 9th month; 54.3% by the 12 months).</p>
</sec>
<sec id="st4"><title>Conclusion:</title>
<p>The carriage rate of faecal <italic>E. coli</italic>
resistant to TMP-SMX is common before TMP-SMX prophylaxis. Initiation of TMP-SMX leads to further increase in resistance to TMP-SMX and cross-resistance to other antimicrobials.</p>
</sec>
</div>
</front>
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<affiliations><list><country><li>Nigeria</li>
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